Individual
RAED A WAHAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 569-7408
Mailing address
PO BOX 255228, SACRAMENTO, CA 95865-5228
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD60740424
WA
207RP1001X
Pulmonary Disease Physician
69074
WI
207RP1001X
Pulmonary Disease Physician
Primary
C161771
CA
207RP1001X
Pulmonary Disease Physician
MD434123
PA
207RP1001X
Pulmonary Disease Physician
MD60740424
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042827
—
WA
Enumeration date
05/17/2007
Last updated
05/30/2024
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