Individual
DR. BENJAMIN VANRAALTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4334 E 53RD ST, DAVENPORT, IA 52807-3039
(563) 322-8877
(563) 322-8375
Mailing address
4334 E 53RD ST, DAVENPORT, IA 52807-3039
(563) 322-8877
(563) 322-8375
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29526
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IA0113241
—
IA
Enumeration date
01/18/2006
Last updated
01/29/2020
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