Healthcare Provider Details

I. General information

NPI: 1588740708
Provider Name (Legal Business Name): JOHN MICHAEL RAHE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9597 BRIDLEWOOD TRL
DAYTON OH
45458-9321
US

IV. Provider business mailing address

9597 BRIDLEWOOD TRL
DAYTON OH
45458-9321
US

V. Phone/Fax

Practice location:
  • Phone: 937-545-5108
  • Fax:
Mailing address:
  • Phone: 937-545-5108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.081280
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number35081280
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: