Provider Demographics
NPI:1841788551
Name:RAINS, MICHAEL IVAN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:IVAN
Last Name:RAINS
Suffix:
Gender:M
Credentials:MD, MPH
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Other - Credentials:
Mailing Address - Street 1:5510 LOYOLA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-8118
Mailing Address - Country:US
Mailing Address - Phone:719-310-2529
Mailing Address - Fax:844-209-0404
Practice Address - Street 1:101 NICOLLS RD
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-5779
Practice Address - Country:US
Practice Address - Phone:631-572-6933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-27
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY3200482083P0500X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine