Healthcare Provider Details

I. General information

NPI: 1982227815
Provider Name (Legal Business Name): GEORGE MICHAEL RAUM DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10660 PARK RD STE 3100
CHARLOTTE NC
28210-8420
US

IV. Provider business mailing address

10660 PARK RD STE 3100
CHARLOTTE NC
28210-8420
US

V. Phone/Fax

Practice location:
  • Phone: 704-863-4878
  • Fax:
Mailing address:
  • Phone: 704-863-4878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number334940
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number103535
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: