| Doctor Name: | CHINTAMENI B RAO |
| NPI Number: | 1053387126 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 4301039874 |
| Business Practice Address: | 901 Lake Shore Dr Ishpeming, MI - 498491367 |
| Business Phone Number: | 9064852668 |
| Business Fax Number: | 9064855676 |
| Mailing Address: | 2837 Us 41 W, MARQUETTE |
| State: | MI |
| Postal Code: | 498552252 |
| Phone Number: | 9062253964 |
| Fax Number: | 9062263875 |
| NPI Enumeration Date: | 02/27/2006 |
| NPI Last Update Date: | 01/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 4301039874 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |