Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | OS012248 | PA |
Y | 207X00000X | Orthopaedic Surgeon | 0S012248 | PA |
NPI | 1245216902 |
---|---|
Provider Name | Dr. David Christopher Raab |
First Address | Malvern, PA 19355-3256 |
Second Address | Malvern, PA 19355-3256 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 28/03/2014 |