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NPI Code Detail

MEDICARE: JENNIFER RAUM

MEDICARE: JENNIFER RAUM
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
1207R00000XInternal Medicine Physician35289DC
2207R00000XInternal Medicine Physician10559ND

General Provider Information

NPI Number : 1306821038
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RAUM
Provider Business Mailing Address
First Line : 2400 32ND AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-5800
Country : US
Telephone Number : 701-234-8820
Fax Number :
Provider Business Practice Location Address
First Line : 2400 32ND AVE S
Second Line :
City : FARGO
State : ND
Zip : 58103-5800
Country : US
Telephone Number : 701-234-8820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 03/29/2022

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Directions to “ JENNIFER RAUM ” Practice Location

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