Provider Demographics
NPI:1578787255
Name:RAU, DAVID ARTHUR
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ARTHUR
Last Name:RAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 DICKERSON RD
Mailing Address - Street 2:
Mailing Address - City:GAGETOWN
Mailing Address - State:MI
Mailing Address - Zip Code:48735-9757
Mailing Address - Country:US
Mailing Address - Phone:810-881-0007
Mailing Address - Fax:
Practice Address - Street 1:3200 DICKERSON RD
Practice Address - Street 2:
Practice Address - City:GAGETOWN
Practice Address - State:MI
Practice Address - Zip Code:48735-9757
Practice Address - Country:US
Practice Address - Phone:810-881-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education