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Individual

MRS. SMITA K RAIKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9038 COLUMBIA AVE, SUITE B, MUNSTER, IN 46321-2905
(219) 836-5758
(219) 836-5774
Mailing address
9038 COLUMBIA AVE, SUITE B, MUNSTER, IN 46321-2905
(219) 836-5758
(219) 836-5774

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01047569
IN
207Q00000X
Family Medicine Physician
036100077
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000485470
ANTHEM
IN
05
200250690
IN
01
7017026
AETNA
IN
01
90001294
BC/BS ILLINOIS
IL
01
P00349431
RAILROAD MEDICARE
IN
Enumeration date
08/01/2006
Last updated
06/11/2008
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