Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 272940 | NY |
N | 207X00000X | Orthopaedic Surgeon | 58003182 | OH |
Y | 207X00000X | Orthopaedic Surgeon | OS015721 | PA |
N | 207XS0117X | Orthopaedic Spine Surgeon | 34.010342 | OH |
NPI | 1356641609 |
---|---|
Provider Name | Dr. Brandon Leroy Raudenbush |
First Address | Chambersburg, PA 17201-4232 |
Second Address | Chambersburg, PA 17201-1720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2010 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0137995 | (05) | OH |
12703418 | CAQH (01) |