Provider Demographics
NPI:1972253771
Name:RASOF, CARY RICHARD (MD)
Entity Type:Individual
Prefix:
First Name:CARY
Middle Name:RICHARD
Last Name:RASOF
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 1:8701 S KOLB RD UNIT 5-271
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-9607
Mailing Address - Country:US
Mailing Address - Phone:678-224-1070
Mailing Address - Fax:
Practice Address - Street 1:8701 S KOLB RD UNIT 5-271
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-9607
Practice Address - Country:US
Practice Address - Phone:678-224-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI32871-020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty