MEDICARE: DR. DANIEL S RAABE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	042-0005592	VT
2	207RC0000X	Cardiovascular Disease Physician	042-0005592	VT

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	060026218	OTHER	VT	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780642892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL S RAABE MD

Provider Business Mailing Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8423
Country	:	US
Telephone Number	:	802-382-3443
Fax Number	:	802-388-5614

Provider Business Practice Location Address
First Line	:	115 PORTER DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8423
Country	:	US
Telephone Number	:	802-382-3443
Fax Number	:	802-388-5614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	10/25/2012

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