MEDICARE: STEPHEN MICHAEL RAUH 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
1	208600000X	Surgery Physician	155502	NY
2	208C00000X	Colon & Rectal Surgery Physician	155502	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD455F	OTHER	NY	PREFERRED CARE
3	P010155501	OTHER	NY	BLUES
4	4655696	OTHER	NY	AETNA

General Provider Information

NPI Number	:	1427018811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN MICHAEL RAUH M.D.

Provider Business Mailing Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 270
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-244-5670
Fax Number	:	585-244-4298

Provider Business Practice Location Address
First Line	:	125 LATTIMORE RD
Second Line	:	SUITE 270
City	:	ROCHESTER
State	:	NY
Zip	:	14620-4159
Country	:	US
Telephone Number	:	585-244-5670
Fax Number	:	585-244-4298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	01/29/2014

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Directions to “ STEPHEN MICHAEL RAUH M.D.” Practice Location

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