Provider Demographics
NPI:1114018595
Name:RAAD, MICHELLE L (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:L
Last Name:RAAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 WILLIAMSON ST STE 503
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3673
Mailing Address - Country:US
Mailing Address - Phone:908-355-1010
Mailing Address - Fax:908-355-5629
Practice Address - Street 1:240 WILLIAMSON ST STE 503
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07202-3673
Practice Address - Country:US
Practice Address - Phone:908-355-1010
Practice Address - Fax:908-355-5629
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05132700207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology