Healthcare Provider Details

I. General information

NPI: 1942395546
Provider Name (Legal Business Name): KAMRAN RAFIQ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1035 W WAYNE ST
PAULDING OH
45879-1544
US

IV. Provider business mailing address

5800 MONROE ST. BLDG E #4
SYLVANIA OH
43560
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-4080
  • Fax: 419-399-3688
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.084518
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.084518
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036.167407
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: