Dr. Benjamin Vanraalte, M.D.
Specialist in Davenport, IA. Individual provider (NPI-1).
NPI number1528048451
StatusActive
Last updated in NPPESJan 29, 2020
Details
- NPI
- 1528048451
- Entity type
- Individual (NPI-1)
- Name
- Dr. Benjamin Vanraalte
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 18, 2006
- Certification date
- Jan 29, 2020
- Last updated
- Jan 29, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 29526 | IA | Yes |
Practice location
4334 E 53rd StDavenport, IA 52807-3039
Phone 563-322-8877 · Fax 563-322-8375
Mailing address
4334 E 53rd StDavenport, IA 52807-3039
Phone 563-322-8877 · Fax 563-322-8375
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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