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General NPI Number Information
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NPI Number | 1972702884
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Entity Type | Organization
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Legal Business Name | GARY ELLIOT RAFFEL D.O., F.A.C.P.
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 5411 W CEDAR LN SUITE 202A
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City | BETHESDA
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State | MD
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Zip | 20814-1516
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Country | US
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Telephone | 301-530-1150
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Fax | 301-260-2838
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Provider Business Mailing Address
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Address Line | PO BOX 157
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City | ASHTON
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State | MD
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Zip | 20861-0157
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Country | US
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Telephone | 301-570-9700
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Fax | 301-260-2838
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Authorized Official
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Title or Position | SOLE PROPRIATOR
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Name | DR. GARY ELLIOT RAFFEL
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Credential | D.O.
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Telephone | 301-570-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | H0045839
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License Number State | MD
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