Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 60326411205 | UT |
N | 207XS0106X | Orthopaedic Hand Surgeon | 6032641-1205 | UT |
Y | 2086S0105X | Surgery of the Hand | 6032641-1205 | UT |
NPI | 1588603039 |
---|---|
Provider Name | Dr. Michael Ernest Raemisch |
First Address | Salt Lake City, UT 84127-0128 |
Second Address | Salt Lake City, UT 84103-2853 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 20/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
942854057012 | (05) | UT |
H75091 | (02) | NV |