| NPI,EntityTypeCode,ReplacementNPI,EmployerIdentificationNumberEIN,ProviderOrganizationNameLegalBusinessName,ProviderLastNameLegalName,ProviderFirstName,ProviderMiddleName,ProviderNamePrefixText,ProviderNameSuffixText,ProviderCredentialText,ProviderOtherOrganizationName,ProviderOtherOrganizationNameTypeCode,ProviderOtherLastName,ProviderOtherFirstName,ProviderOtherMiddleName,ProviderOtherNamePrefixText,ProviderOtherNameSuffixText,ProviderOtherCredentialText,ProviderOtherLastNameTypeCode,ProviderFirstLineBusinessMailingAddress,ProviderSecondLineBusinessMailingAddress,ProviderBusinessMailingAddressCityName,ProviderBusinessMailingAddressStateName,ProviderBusinessMailingAddressPostalCode,ProviderBusinessMailingAddressCountryCodeIfoutsideUS,ProviderBusinessMailingAddressTelephoneNumber,ProviderBusinessMailingAddressFaxNumber,ProviderFirstLineBusinessPracticeLocationAddress,ProviderSecondLineBusinessPracticeLocationAddress,ProviderBusinessPracticeLocationAddressCityName,ProviderBusinessPracticeLocationAddressStateName,ProviderBusinessPracticeLocationAddressPostalCode,ProviderBusinessPracticeLocationAddressCountryCodeIfoutsideUS,ProviderBusinessPracticeLocationAddressTelephoneNumber,ProviderBusinessPracticeLocationAddressFaxNumber,ProviderEnumerationDate,LastUpdateDate,NPIDeactivationReasonCode,NPIDeactivationDate,NPIReactivationDate,ProviderGenderCode,AuthorizedOfficialLastName,AuthorizedOfficialFirstName,AuthorizedOfficialMiddleName,AuthorizedOfficialTitleorPosition,AuthorizedOfficialTelephoneNumber,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch,HealthcareProviderTaxonomyCode,ProviderLicenseNumber,ProviderLicenseNumberStateCode,HealthcareProviderPrimaryTaxonomySwitch | |
| 1164518114,1,,,,RASCH,MICHAEL,W.,MR.,,C.P.O.,,,,,,,,,,1691 GALISTEO STREET,SUITE B,SANTA,FE,87505,UM,5058202390,5058202392,1691 GALISTEO ST,SUITE B,SANTA FE,NM,875054780,US,5058202390,5058202392,10/05/2006,04/11/2014,,,,M,,,,,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE,,225000000X,CPO 1456,DE, | |