Provider Demographics
NPI:1588740708
Name:RAHE, JOHN MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MICHAEL
Last Name:RAHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9597 BRIDLEWOOD TRL
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-9321
Mailing Address - Country:US
Mailing Address - Phone:937-545-5108
Mailing Address - Fax:
Practice Address - Street 1:9597 BRIDLEWOOD TRL
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-9321
Practice Address - Country:US
Practice Address - Phone:937-545-5108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350812802080A0000X
OH35.081280208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2344734Medicaid
2909675OtherAETNA
000000231452OtherBLUE CROSS BLUE SHIELD
1203966OtherUNITED HEALTHCARE
2344734OtherBUREAU FOR CHILDREN WITH
311627276035OtherCARESOURCE