Provider Demographics
NPI:1275832081
Name:ALQUIST, CAROLINE RAASCH (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:RAASCH
Last Name:ALQUIST
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 HIGHLAND AVE 5TH FLOOR TID HOXWORTH BLDG TID
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-2429
Mailing Address - Country:US
Mailing Address - Phone:513-558-1515
Mailing Address - Fax:
Practice Address - Street 1:3130 HIGHLAND AVE 5TH FLOOR TID HOXWORTH BLDG TID
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-2429
Practice Address - Country:US
Practice Address - Phone:513-558-1515
Practice Address - Fax:504-842-3126
Is Sole Proprietor?:No
Enumeration Date:2011-03-18
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.206912207ZP0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2149547Medicaid
MS05281265Medicaid
LA536773YH3UMedicare PIN
LA2149547Medicaid