Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 35.08-8334 | OH |
N | 207QA0505X | Family Doctor - Adult Medicine | 35088334 | OH |
N | 207R00000X | Internist | 35088334 | OH |
N | 111NI0900X | Internist | 35088334 | OH |
NPI | 1003852070 |
---|---|
Provider Name | Robert Sean Rae |
First Address | Cincinnati, OH 45212-3397 |
Second Address | Montgomery, OH 45242-4402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 26/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000497140 | ANTHEM (01) | OH |
000000522443 | ANTHEM (01) | OH |
06186 | PARAMOUNT (01) | OH |
2677063 | (05) | OH |
297706983 | TRICARE (01) | OH |
4997740 | (05) | MI |
7861831 | AETNA (01) | OH |
I63225 | (02) | OH |
P00434160 | RRMC (01) | OH |