MEDICARE: DANIEL RAWN EMIG 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	2085R0202X	Diagnostic Radiology Physician	01063013A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00413504	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972657633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RAWN EMIG M.D.

Provider Business Mailing Address
First Line	:	3662 N WINIFRED WAY
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-5959
Country	:	US
Telephone Number	:	219-682-8738
Fax Number	:	928-466-9314

Provider Business Practice Location Address
First Line	:	3662 N WINIFRED WAY
Second Line	:
City	:	LAKE HAVASU CITY
State	:	AZ
Zip	:	86404-5959
Country	:	US
Telephone Number	:	219-682-8738
Fax Number	:	928-466-9314

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/16/2013

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