Healthcare Provider Details
I. General information
NPI: 1245216902
Provider Name (Legal Business Name): DAVID CHRISTOPHER RAAB D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/15/2005
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
266 LANCASTER AVE SUITE 200
MALVERN PA
19355-3256
US
IV. Provider business mailing address
PO BOX 34990
BELFAST ME
04915-0627
US
V. Phone/Fax
- Phone: 610-644-6900
- Fax: 833-941-3871
- Phone: 610-644-6900
- Fax: 833-941-3871
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204C00000X |
| Taxonomy | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
| License Number | OS012248 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 0S012248 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: