Individual
GARY PAIGE RAKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 ROLKIN CT, SUITE 102, CHARLOTTESVILLE, VA 22911-3642
(434) 951-2191
(434) 977-0200
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101050099
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y223A01
MEDICARE PTAN
VA
05
—
1245277037
—
VA
Enumeration date
06/01/2006
Last updated
10/31/2023
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