Provider Demographics
NPI:1073678207
Name:RABEL, MICHAEL NUSS
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:NUSS
Last Name:RABEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3114 GROOM RD
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-3402
Mailing Address - Country:US
Mailing Address - Phone:225-775-0160
Mailing Address - Fax:225-775-0230
Practice Address - Street 1:3114 GROOM RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-3402
Practice Address - Country:US
Practice Address - Phone:225-775-0160
Practice Address - Fax:225-775-0230
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA55011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice