Provider Demographics
NPI:1023356680
Name:RAUCHWAY, MICHAEL I (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:I
Last Name:RAUCHWAY
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 1:3216 EL CENTRO ST
Mailing Address - Street 2:C
Mailing Address - City:ST PETE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33706-3957
Mailing Address - Country:US
Mailing Address - Phone:727-360-9233
Mailing Address - Fax:
Practice Address - Street 1:3216 EL CENTRO ST
Practice Address - Street 2:C
Practice Address - City:ST PETE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33706-3957
Practice Address - Country:US
Practice Address - Phone:727-360-9233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME254582085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology