Individual
DR. JEREMY M RAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 RYAN ST, SUITE 105, LAKE CHARLES, LA 70601-6078
(337) 439-4706
Mailing address
1800 RYAN ST, SUITE 105, LAKE CHARLES, LA 70601-6078
(337) 439-4706
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
205959
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09120711
—
MS
05
—
1457833
—
LA
Enumeration date
06/13/2008
Last updated
11/11/2015
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