Provider Demographics
NPI:1811556012
Name:RAWLINS-RADER, AUGUSTA MALIN (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTA
Middle Name:MALIN
Last Name:RAWLINS-RADER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AUGUSTA
Other - Middle Name:MALIN RAWLINS
Other - Last Name:RADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2100 SHERMAN AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2791
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:
Practice Address - Street 1:1955 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2792
Practice Address - Country:US
Practice Address - Phone:859-341-5757
Practice Address - Fax:859-331-4757
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY55673207Q00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine