Provider Demographics
NPI:1306080536
Name:RAUS, ADRIANA (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:RAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 WAUGH RD
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9746
Mailing Address - Country:US
Mailing Address - Phone:517-220-0603
Mailing Address - Fax:517-212-9949
Practice Address - Street 1:2289 SOWER BLVD
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3297
Practice Address - Country:US
Practice Address - Phone:517-220-0603
Practice Address - Fax:517-212-9949
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAR094783207Q00000X
MI4301094783207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty