Provider Demographics
NPI:1164595880
Name:RAUB, DANIEL JOSEPH (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:JOSEPH
Last Name:RAUB
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:705 OAKWOOD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-2191
Mailing Address - Country:US
Mailing Address - Phone:330-296-9919
Mailing Address - Fax:330-297-3597
Practice Address - Street 1:705 OAKWOOD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-2191
Practice Address - Country:US
Practice Address - Phone:330-296-9919
Practice Address - Fax:330-297-3597
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34003561R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine