MEDICARE: RICHARD W RAFAEL MD CHARTERED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	5289	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083929723
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD W RAFAEL MD CHARTERED

Provider Business Mailing Address
First Line	:	770 MILL ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1321
Country	:	US
Telephone Number	:	775-323-4545
Fax Number	:	775-323-4869

Provider Business Practice Location Address
First Line	:	770 MILL ST
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89502-1321
Country	:	US
Telephone Number	:	775-323-4545
Fax Number	:	775-323-4869

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD W RAFAEL
Credential	:	M.D.
Telephone Number	:	775-323-4545

Provider Enumeration Date	:	08/17/2010
Last Update Date	:	08/17/2010

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