Provider Demographics
NPI:1013996008
Name:RATH, MICHAEL B (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:B
Last Name:RATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1230 E MAIN ST
Mailing Address - Street 2:PO BOX 8674 MANKATO CLINIC LTD
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8674
Mailing Address - Country:US
Mailing Address - Phone:507-625-1811
Mailing Address - Fax:
Practice Address - Street 1:1809 ADAMS ST
Practice Address - Street 2:MANKATO CLINIC @ ADAMS STREET
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4841
Practice Address - Country:US
Practice Address - Phone:507-625-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2011-08-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN22937207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0101172OtherMEDICA
MN238287300Medicaid
MNHP25865OtherHEALTH PARTNERS
MN1694592OtherAMERICAS PPO
IA938357Medicaid
MNNA2951023857OtherPREFERRED ONE
MN120210OtherUCARE
41084933956001C036OtherCHAMPUS
080068439OtherRR MEDICARE
MN18149RAOtherBCBS
MN0101172OtherMEDICA
MN238287300Medicaid