Individual
DR. GLENN T RAUCHWARG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5424 DISCOVERY PARK BLVD, SUITE 201, WILLIAMSBURG, VA 23188
(757) 345-2071
(757) 903-4877
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102050179
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010114349
—
VA
Enumeration date
02/22/2006
Last updated
02/10/2020
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