Individual
RENATA B. RAEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000741
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1651005-00
—
MD
05
—
1651005-01
—
MD
05
—
1651005-02
—
MD
05
—
1651005-03
—
MD
05
—
1699857003
—
VA
05
—
30015392870001
—
VA
Enumeration date
10/19/2006
Last updated
04/09/2024
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