Provider Demographics
NPI:1487422754
Name:RARA, JAIBEN MICAH (DVM)
Entity type:Individual
Prefix:DR
First Name:JAIBEN
Middle Name:MICAH
Last Name:RARA
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 OSPREY WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-1919
Mailing Address - Country:US
Mailing Address - Phone:301-662-6029
Mailing Address - Fax:
Practice Address - Street 1:2450 OSPREY WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-1919
Practice Address - Country:US
Practice Address - Phone:301-662-6029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty