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Individual
COLIN R RAITIERE
Active
Individual
COLIN R RAITIERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19619
KY
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
19619
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000323180
ANTHEM BC/BS
KY
05
—
64196199
—
KY
01
—
P00156824
RAILROAD MEDICARE
—
Enumeration date
01/26/2006
Last updated
07/30/2010
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