Healthcare Provider Details
I. General information
NPI: 1598877003
Provider Name (Legal Business Name): ROBERT C RAU MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3545 OLENTANGY RIVER RD SUITE 124
COLUMBUS OH
43214-3907
US
IV. Provider business mailing address
3545 OLENTANGY RIVER RD SUITE 124
COLUMBUS OH
43214-3907
US
V. Phone/Fax
- Phone: 614-268-2748
- Fax: 614-263-3376
- Phone: 614-268-2748
- Fax: 614-263-3376
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
C
RAU
Title or Position: OWNER PRESIDENT
Credential: MD
Phone: 614-268-2748