Individual
RAYMOND DATTILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 SW COLLEGE AVE, TOPEKA, KS 66606-1684
(785) 233-9643
(785) 233-6821
Mailing address
DEPT CH 14389, PALATINE, IL 60055-4389
(785) 233-9643
(785) 233-6821
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
04-22168
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
018237
BCBS KANSAS
KS
01
—
060020423
RAILROAD MEDICARE
KS
05
—
100208620A
—
KS
Enumeration date
03/22/2006
Last updated
03/20/2013
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