Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0204X | Pediatric Emergency Doctor | D77127 | MD |
Y | 2080P0204X | Pediatric Emergency Doctor | MD041251 | DC |
NPI | 1275837114 |
---|---|
Provider Name | Dr. Mordechai David Raskas |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2011 |
Last Update Date | 09/10/2017 |