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General NPI Number Information
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NPI Number | 1538328869
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Entity Type | Individual
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Provider Name | MARYUM RAFIQUE DO
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Gender | Female
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 12/08/2024
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Provider Practice Location Address
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Address Line | 100 BECKS WOODS DR STE 201
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City | BEAR
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State | DE
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Zip | 19701-3835
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Country | US
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Telephone | 855-932-7426
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Fax |
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Provider Business Mailing Address
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Address Line | 100 BECKS WOODS DR STE 201
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City | BEAR
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State | DE
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Zip | 19701-3835
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Country | US
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Telephone | 855-932-7426
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Fax | 833-392-7426
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | CS0011174
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS015320
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License Number State | PA
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