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General NPI Number Information
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NPI Number | 1225008790
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Entity Type | Individual
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Provider Name | MICHAEL RAPHELSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 222 N KALAMAZOO MALL STE 100
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City | KALAMAZOO
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State | MI
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Zip | 49007-3882
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Country | US
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Telephone | 269-345-0273
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Fax |
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Provider Business Mailing Address
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Address Line | 601 JOHN STREET BOX 42
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City | KALAMAZOO
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State | MI
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Zip | 49007
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301069625
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 4301069625
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License Number State | MI
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