Healthcare Provider Details

I. General information

NPI: 1881766293
Provider Name (Legal Business Name): RAFAY S MEHDI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 EAST ST
HANOVER MA
02339-1638
US

IV. Provider business mailing address

20 EAST ST
HANOVER MA
02339-1638
US

V. Phone/Fax

Practice location:
  • Phone: 781-826-3146
  • Fax:
Mailing address:
  • Phone: 781-826-3146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number154953
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: