Individual
DR. MEGAN RACCUIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
375 APPLE TREE DR, IONIA, MI 48846-7506
(616) 527-1790
Mailing address
375 APPLE TREE DR, IONIA, MI 48846-7506
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301110061
MI
2084P0800X
Psychiatry Physician
Primary
4351026984
MI
2084P0800X
Psychiatry Physician
5315076684
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301502174
MICHIGAN PHYSICIAN LICENSE
MI
01
—
5315216035
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
06/08/2016
Last updated
01/14/2021
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