Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MA0795530 | NJ |
NPI | 1619040847 |
---|---|
Provider Name | John D Rauth JR. |
First Address | Camden, NJ 08103-1438 |
Second Address | Camden, NJ 08103-1461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 07/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01007819700 | AMERICHOICE (01) | NJ |
0125393 | (05) | NJ |
1455582/3330327 | AETNA (01) | NJ |
1552470 | UNITED HEALTHCARE (01) | NJ |
2813899000 | AMERIHEALTH/KEYSTONE/IBC (01) | NJ |
60030289 | HORIZON NJ HEALTH (01) | NJ |
8600556 | CIGNA (01) | NJ |
B35037 | (02) |