MEDICARE: SHAWN RAFIAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	4704428651	MI

General Provider Information

NPI Number	:	1255202107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN RAFIAL

Provider Business Mailing Address
First Line	:	747 KENTUCKY DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-3739
Country	:	US
Telephone Number	:	586-400-9081
Fax Number	:

Provider Business Practice Location Address
First Line	:	747 KENTUCKY DR
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-3739
Country	:	US
Telephone Number	:	586-400-9081
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	10/24/2025

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Directions to “ SHAWN RAFIAL ” Practice Location

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