Healthcare Provider Details

I. General information

NPI: 1497596449
Provider Name (Legal Business Name): RAFAEL FELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2024
Last Update Date: 12/13/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 E. GALBRAITH ROAD
CINCINNATI OH
45236
US

IV. Provider business mailing address

4777 E. GALBRAITH ROAD
CINCINNATI OH
45236
US

V. Phone/Fax

Practice location:
  • Phone: 416-825-3586
  • Fax: 513-686-6868
Mailing address:
  • Phone: 416-825-3586
  • Fax: 513-686-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: