Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | 36.003771 | OH |
N | 213ER0200X | Radiology | 36.003771 | OH |
N | 2081S0010X | Sports Medicine | 36.003771 | OH |
N | 213ES0000X | Sports Medicine | 36.003771 | OH |
Y | 213ES0103X | Foot & Ankle Surgery | 36.003771 | OH |
NPI | 1043622095 |
---|---|
Provider Name | Dr. Jennalee Rauh |
First Address | Lima, OH 45805-2725 |
Second Address | Celina, OH 45822-2229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0226865 | (05) | OH |
2348856 | (05) | OH |
CB6624 | RAILROAD MEDICARE (01) | OH |
Q00033069 | RAILROAD MEDICARE (01) | OH |