Provider Demographics
NPI:1770540940
Name:TRUEX, RAYMOND C (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:C
Last Name:TRUEX
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 1:601 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1496
Mailing Address - Country:US
Mailing Address - Phone:610-375-4567
Mailing Address - Fax:610-685-8801
Practice Address - Street 1:601 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1496
Practice Address - Country:US
Practice Address - Phone:610-375-4567
Practice Address - Fax:610-685-8801
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010475E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA174827R1XOtherMEDICARE ID
PA01689201OtherCAPITAL BLUE CROSS
PA174827OtherHIGHMARK BLUE SHIELD
PA0006814780001Medicaid
PA5431137OtherAETNA PPO
PA116567600OtherUS DEPT OF LABOR
PA140001336OtherRAILROAD MEDICARE
PA5554OtherHEALTH AMERICA
PA1639OtherAETNA HMO
PA140001336OtherRAILROAD MEDICARE