MEDICARE: DR. MARY H RABB D.O.

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	207Q00000X	Family Medicine Physician	34005190R	OH

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

General Provider Information

NPI Number	:	1598750556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY H RABB D.O.

Provider Business Mailing Address
First Line	:	266 VISTA CIR
Second Line	:
City	:	NORTH OLMSTED
State	:	OH
Zip	:	44070-5711
Country	:	US
Telephone Number	:	440-979-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	11201 SHAKER BLVD
Second Line	:	240
City	:	CLEVELAND
State	:	OH
Zip	:	44104-3869
Country	:	US
Telephone Number	:	216-791-0017
Fax Number	:	216-791-0021

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	07/11/2007

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