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NPI Code Detail

MEDICARE: RAUL C BANAGALE M.D.

MEDICARE:   RAUL C BANAGALE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician21075IA
22080N0001XNeonatal-Perinatal Medicine Physician21075IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043271406
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAUL C BANAGALE M.D.
Provider Business Mailing Address
First Line : 2720 STONE PARK BLVD
Second Line :
City : SIOUX CITY
State : IA
Zip : 51104-3734
Country : US
Telephone Number : 712-279-3789
Fax Number : 712-279-3613
Provider Business Practice Location Address
First Line : 2720 STONE PARK BLVD
Second Line :
City : SIOUX CITY
State : IA
Zip : 51104-3734
Country : US
Telephone Number : 712-279-3789
Fax Number : 712-279-3613
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 12/02/2009

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Directions to “ RAUL C BANAGALE M.D.” Practice Location

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