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General NPI Number Information
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NPI Number | 1558368704
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Entity Type | Individual
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Provider Name | DAVID MARK RAFALKO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/02/2005
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Last Update Date | 10/01/2007
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Provider Practice Location Address
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Address Line | 1301 RIVERSIDE DR
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City | BEAVER
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State | PA
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Zip | 15009-3116
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Country | US
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Telephone | 724-728-7800
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Fax | 724-728-8115
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Provider Business Mailing Address
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Address Line | 1301 RIVERSIDE DR
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City | BEAVER
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State | PA
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Zip | 15009-3116
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Country | US
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Telephone | 724-728-7800
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Fax | 724-728-8115
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | MD016925E
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License Number State | PA
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