Provider Demographics
NPI:1285954743
Name:RAITZ-COWBOY, ELIZABETHANN NADINE (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETHANN
Middle Name:NADINE
Last Name:RAITZ-COWBOY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:999 EXECUTIVE PARKWAY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6336
Mailing Address - Country:US
Mailing Address - Phone:314-514-6000
Mailing Address - Fax:866-497-1239
Practice Address - Street 1:999 EXECUTIVE PARKWAY DR STE 210
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6336
Practice Address - Country:US
Practice Address - Phone:314-514-6000
Practice Address - Fax:866-497-1239
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010017192207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine