Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | RR007981 | MI |
Y | 208600000X | Surgeon | RR007981 | MI |
NPI | 1023022480 |
---|---|
Provider Name | Richard Allen Rahall |
First Address | Bay City, MI 48706 |
Second Address | Bay City, MI 48706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 01/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1641000 | (05) | MI |
E26665 | (02) | |
P60500 | BCN (01) | MI |
RR007981 | LIC (01) | MI |