Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 107112 | MO |
NPI | 1073502977 |
---|---|
Provider Name | Dr. David S Raskas |
First Address | Saint Louis, MO 63131-2930 |
Second Address | Saint Louis, MO 63131-2930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2005 |
Last Update Date | 02/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F87491 | (02) |