Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 19029 | MD |
Y | 2251X0800X | Physical Therapist - Orthopedic | 19029 | MD |
NPI | 1003147422 |
---|---|
Provider Name | Dr. Michael C Rabel |
First Address | Crisfield, MD 21817-1237 |
Second Address | Crisfield, MD 21817-1237 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2010 |
Last Update Date | 25/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19029 | LICENSE (01) | MD |