Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 082885 | IA |
N | 213ES0103X | Foot & Ankle Surgery | 2009017428 | MO |
N | 213ES0103X | Foot & Ankle Surgery | 329 | NE |
N | 213ES0131X | Foot Surgery | 082885 | IA |
NPI | 1306175104 |
---|---|
Provider Name | Dr. Justin J. Raatz |
First Address | Des Moines, IA 50309-2057 |
Second Address | Des Moines, IA 50309-2057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2009 |
Last Update Date | 04/12/2018 |