Provider Demographics
NPI:1881673986
Name:RAAB, CLAYTON L (MD)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:L
Last Name:RAAB
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 1:3910 GOLD HAWK MEWS
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-2531
Mailing Address - Country:US
Mailing Address - Phone:410-546-1402
Mailing Address - Fax:
Practice Address - Street 1:3910 GOLD HAWK MEWS
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-2531
Practice Address - Country:US
Practice Address - Phone:410-546-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0019289207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD319351900Medicaid
VA010199336Medicaid
4404953OtherAETNA
262255OtherCOVENTRY
343883OtherUNITED HEALTHCARE
P0022143OtherMEDDICARE RAILROAD
4696048OtherCIGNA
10000022830OtherDELAWARE PHY.
DCJ333-0002OtherBLUE CROSS
DE000017371Medicaid
MD41953706OtherBLUE CROSS
10000022830OtherDELAWARE PHY.
343883OtherUNITED HEALTHCARE