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NPI Code Detail

MEDICARE: DR. GLENN FRANCIS RAGALIE M.D.

MEDICARE: DR. GLENN FRANCIS RAGALIE 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
1207RP1001XPulmonary Disease Physician21819WI

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 : 1740382555
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLENN FRANCIS RAGALIE M.D.
Provider Business Mailing Address
First Line : 1621 CHURCH ST
Second Line :
City : WAUWATOSA
State : WI
Zip : 53213-2541
Country : US
Telephone Number : 414-258-7498
Fax Number :
Provider Business Practice Location Address
First Line : 1155 N HONEY CREEK PKWY
Second Line :
City : WAUWATOSA
State : WI
Zip : 53213-3189
Country : US
Telephone Number : 414-615-5936
Fax Number : 414-615-5927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 01/30/2017

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