Provider Demographics
NPI:1558397273
Name:RAKOWSKI, RONALD THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:THOMAS
Last Name:RAKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6111 RIVER VIEW CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-6667
Mailing Address - Country:US
Mailing Address - Phone:301-696-1495
Mailing Address - Fax:
Practice Address - Street 1:6111 RIVER VIEW CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-6667
Practice Address - Country:US
Practice Address - Phone:301-696-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057181207P00000X
PAMD450395207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD762671100Medicaid
MD950100200Medicaid
MDH10995Medicare UPIN
MDH733Medicare ID - Type UnspecifiedMEDICARE GRP #