Provider Demographics
NPI:1457354003
Name:RASKIN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:RASKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6622 N. 91ST AVE.,
Mailing Address - Street 2:SUITE 220
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85305
Mailing Address - Country:US
Mailing Address - Phone:602-759-6883
Mailing Address - Fax:602-224-3358
Practice Address - Street 1:9100 N 2ND ST
Practice Address - Street 2:SUITE 221,
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2446
Practice Address - Country:US
Practice Address - Phone:602-943-1231
Practice Address - Fax:602-395-9574
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2017-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ20286207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ56863Medicaid
AZ56863Medicaid
D41839Medicare UPIN