Healthcare Provider Details

I. General information

NPI: 1821088048
Provider Name (Legal Business Name): RAAFAT Z ABDEL-MISIH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 OGLETOWN STANTON RD SUITE 4000
NEWARK DE
19713-2055
US

IV. Provider business mailing address

4701 OGLETOWN STANTON RD SUITE 4000
NEWARK DE
19713-2055
US

V. Phone/Fax

Practice location:
  • Phone: 302-658-7533
  • Fax:
Mailing address:
  • Phone: 302-658-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberC1-0001752
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: