Provider Demographics
NPI:1275504029
Name:RAKOWSKI, DANIEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:RAKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4445 CORPORATION LN STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3666
Mailing Address - Country:US
Mailing Address - Phone:757-623-0005
Mailing Address - Fax:757-548-1129
Practice Address - Street 1:300 MEDICAL PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4985
Practice Address - Country:US
Practice Address - Phone:757-623-0005
Practice Address - Fax:757-410-7349
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA010129882207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1275504029Medicaid