Provider Demographics
NPI:1043742125
Name:RAUCH, ADINA (PA)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:RAUCH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2 PARK CENTER CT
Mailing Address - Street 2:STE 200
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4295
Mailing Address - Country:US
Mailing Address - Phone:443-693-7246
Mailing Address - Fax:443-450-3204
Practice Address - Street 1:7920 MCDONOGH RD
Practice Address - Street 2:201
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5273
Practice Address - Country:US
Practice Address - Phone:443-693-7246
Practice Address - Fax:443-450-3204
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDC0006379363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical