Provider Demographics
NPI:1245293653
Name:MCELHINNY-RAAP, JUDITH L (DO)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:L
Last Name:MCELHINNY-RAAP
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-583-0100
Mailing Address - Fax:989-583-0108
Practice Address - Street 1:5570 STATE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3583
Practice Address - Country:US
Practice Address - Phone:989-583-0100
Practice Address - Fax:989-583-0108
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013380207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700Z946010OtherBLUE CROSS BLUE SHIELD
MI01002501OtherHEALTHPLUS
MI1015703OtherMCLAREN HEALTH PLAN
MI4812934Medicaid
MI1015703OtherHEALTH ADVANTAGE
MI700Z946010OtherCOMMUNITY BLUE
MI4812934Medicaid
MI1015703OtherMCLAREN HEALTH PLAN