Individual
JAMES D. RAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
149 NORTH STREET, WATERVILLE, ME 04901-4974
(207) 873-0729
(207) 873-4338
Mailing address
PO BOX 766, WATERVILLE, ME 04901-0766
(207) 873-0729
(207) 873-4338
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
017660
ME
2085R0204X
Vascular & Interventional Radiology Physician
Primary
017660
ME
2085R0204X
Vascular & Interventional Radiology Physician
42012
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043222334
—
ME
05
—
50973550
—
CO
Enumeration date
08/13/2006
Last updated
08/15/2011
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