MEDICARE: KHALIL A RAFFOUL M.D.

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	207W00000X	Ophthalmology Physician	35070799	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	180027814	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0004651135	OTHER	AETNA
2	02267	OTHER	PARAMOUNT
3	1427801	OTHER	UNITED HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000127266	OTHER	ANTHEM

General Provider Information

NPI Number	:	1407851736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALIL A RAFFOUL M.D.

Provider Business Mailing Address
First Line	:	1000 REGENCY CT
Second Line	:	STE 100
City	:	TOLEDO
State	:	OH
Zip	:	43623-3074
Country	:	US
Telephone Number	:	419-882-0588
Fax Number	:	419-885-3070

Provider Business Practice Location Address
First Line	:	1000 REGENCY CT
Second Line	:	STE 100
City	:	TOLEDO
State	:	OH
Zip	:	43623-3074
Country	:	US
Telephone Number	:	419-882-0588
Fax Number	:	419-885-3070

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	04/13/2021

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Directions to “ KHALIL A RAFFOUL M.D.” Practice Location

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