Healthcare Provider Details

I. General information

NPI: 1083364574
Provider Name (Legal Business Name): MICHELLE ELIZABETH RAABE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20630 ROUTE 19 UNIT 101
CRANBERRY TOWNSHIP PA
16066-6021
US

IV. Provider business mailing address

20630 ROUTE 19 UNIT 101
CRANBERRY TOWNSHIP PA
16066-6021
US

V. Phone/Fax

Practice location:
  • Phone: 724-779-2273
  • Fax: 724-779-3006
Mailing address:
  • Phone: 724-779-2273
  • Fax: 724-779-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS026000
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS026000
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: