Provider Demographics
NPI:1336230481
Name:RABISH, MARGARET MOEN I (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:MOEN
Last Name:RABISH
Suffix:I
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:MOEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1900 44TH ST SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-5008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:245 CHERRY ST SE
Practice Address - Street 2:STE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4607
Practice Address - Country:US
Practice Address - Phone:616-685-6330
Practice Address - Fax:616-685-3010
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMM0506422084N0400X
MI43010506422084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI124729OtherPRFERRED CHOICES
MI1302810101OtherBCBSM
MI1014033OtherMCLAREN HEALTH
MI4594192Medicaid
MIQMXPR0026630OtherMOLINA
MI810638656051OtherCOMMUNITY CHOICE MICHIGAN
MIP00116249OtherRR MEDICARE
MIP00116249OtherRR MEDICARE
MI81-0638656OtherEMPLOYER ID NUMBER
MI1302810101OtherBCBSM