Provider Demographics
NPI:1184734154
Name:RAKARIC, ILIJA STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:ILIJA
Middle Name:STEVEN
Last Name:RAKARIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1920 MEDICAL AVE
Mailing Address - Street 2:STE F
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-8016
Mailing Address - Country:US
Mailing Address - Phone:540-908-3095
Mailing Address - Fax:540-908-3085
Practice Address - Street 1:1920 MEDICAL AVE
Practice Address - Street 2:STE F
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-8016
Practice Address - Country:US
Practice Address - Phone:540-908-3095
Practice Address - Fax:540-908-3085
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101054605207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006023169Medicaid
VA110006903Medicare ID - Type Unspecified
VAG30913Medicare UPIN