Provider Demographics
NPI:1720002215
Name:RAKER, JAMES HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HOWARD
Last Name:RAKER
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 1:7 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3415
Mailing Address - Country:US
Mailing Address - Phone:207-841-8671
Mailing Address - Fax:207-729-8483
Practice Address - Street 1:51 WINSHIP ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2843
Practice Address - Country:US
Practice Address - Phone:207-841-8671
Practice Address - Fax:207-729-8483
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012491207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME079133OtherANTHEM
ME119170000Medicaid
MEB86446OtherHARVARD PILGRIM
MEMM1111Medicare PIN
ME079133OtherANTHEM
ME110229069Medicare PIN