Individual
DAVID MICHAEL RAEZER
Active
Individual
DAVID MICHAEL RAEZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD030565L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007379020002
—
PA
05
—
0007380240001
—
PA
01
—
0031117000
PERSONAL CHOICE ID
PA
01
—
0073802406
AMERICHOICE ID #
PA
01
—
025027
BLAIR MILL ADMINISTRATORS
PA
01
—
1202110002
CIGNA
PA
01
—
12459
ELDER HEALTH ID#
PA
01
—
146871
BLUE SHIELD PROVIDER #
PA
01
—
2327902
NJ MEDICAID PROVIDER #
NJ
01
—
36158333
MULTIPLAN ID#
PA
01
—
4088087
AETNA PROVIDER #
PA
01
—
CL6874
RAILROAD MEDICARE GROUP #
PA
01
—
DES178
OXFORD HEALTH PLAN ID #
PA
01
—
P00252734
RAILROAD MEDICARE ID
PA
01
—
P0034748
TRICARE PROVIDER ID #
PA
Enumeration date
09/20/2006
Last updated
05/07/2020
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