Provider Demographics
NPI:1780768176
Name:RAUK, PHILLIP N (MD)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:N
Last Name:RAUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 DELAWARE STREET SE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-273-2223
Mailing Address - Fax:
Practice Address - Street 1:606 24TH AVENUE SOUTH, SUITE 400
Practice Address - Street 2:MATERNAL-FETAL MEDICINE CENTER
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-273-2223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN45471207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN07-02800OtherMEDICA PRIMARY
MT0059942Medicaid
MN1033735OtherPREFERRED ONE
MN171377OtherUCARE
MN07-03291OtherMEDICA CHOICE
MN1835197OtherARAZ
MN155188400Medicaid
MN514A8RAOtherBLUE CROSS BLUE SHIELD
MNHP40484OtherHEALTH PARNTERS
MN07-03291OtherMEDICA CHOICE
MNHP40484OtherHEALTH PARNTERS