Provider Demographics
NPI:1427006394
Name:RAWDIN, MARTIN (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:
Last Name:RAWDIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-0293
Mailing Address - Country:US
Mailing Address - Phone:610-326-7977
Mailing Address - Fax:610-323-3788
Practice Address - Street 1:1630 HIGH STREET
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19454-0293
Practice Address - Country:US
Practice Address - Phone:610-323-8007
Practice Address - Fax:610-323-3788
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0139250001Medicare NSC
PARA283489Medicare PIN
PAU01007Medicare UPIN