Individual
ELLIOT G RAIZES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1960 RIVERSIDE PKWY, SUITE 101, LAWRENCEVILLE, GA 30043-5945
(770) 995-0466
(770) 995-0472
Mailing address
1960 RIVERSIDE PKWY, SUITE 101, LAWRENCEVILLE, GA 30043-5945
(770) 995-0466
(770) 995-0472
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
024478
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00344847A
—
GA
01
—
28131
BLUE CROSS BLUE SHIELD
—
05
—
309509
—
GA
01
—
581958199
CHAMPUS
—
01
—
85000553G
GEORGIA BETTER HEALTHCARE
GA
01
—
9202955
UNITED HEALTH CARE
—
Enumeration date
08/01/2006
Last updated
07/23/2012
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