Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 219352 | NY |
NPI | 1205985645 |
---|---|
Provider Name | Dr. Michael Alfred Rauh |
First Address | Orchard Park, NY 14127-2291 |
Second Address | Orchard Park, NY 14127-2291 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 20/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02142487 | (05) | NY |