MEDICARE: DAVID RAEL

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	237700000X	Hearing Instrument Specialist	2653	MN

General Provider Information

NPI Number	:	1649479049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID RAEL

Provider Business Mailing Address
First Line	:	5000 CHESHIRE LN N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55446-3706
Country	:	US
Telephone Number	:	888-333-9152
Fax Number	:	763-268-4240

Provider Business Practice Location Address
First Line	:	4723 HIAWATHA AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-3928
Country	:	US
Telephone Number	:	612-721-6338
Fax Number	:	612-729-8378

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	07/16/2007

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