Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 12007559 | IN |
Y | 213EG0000X | General Practice | 12007559 | IN |
N | 1223P0700X | Prosthodontist | 12007559 | IN |
NPI | 1114117405 |
---|---|
Provider Name | Dr. Robin I Raub |
First Address | Noblesville, IN 46062 |
Second Address | Noblesville, IN 46062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 01/08/2007 |