Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 22268 | NC |
NPI | 1063408714 |
---|---|
Provider Name | Dr. Mary J Raab |
First Address | Charlotte, NC 28275-1069 |
Second Address | Greenville, NC 27834-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 06/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
69752 | BCBS NC (01) | NC |
830002854 | RAILROAD MEDICARE (01) | NC |
8969752 | (05) | NC |
C86088 | (02) | NC |