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NPI Code Detail

MEDICARE: DR. UNKNOWN RAFAQAT MD

MEDICARE: DR. UNKNOWN RAFAQAT MD
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
1207R00000XInternal Medicine Physician336798LA

General Provider Information

NPI Number : 1366050742
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. UNKNOWN RAFAQAT MD
Provider Business Mailing Address
First Line : 1001 GAUSE BLVD
Second Line :
City : SLIDELL
State : LA
Zip : 70458-2987
Country : US
Telephone Number : 985-280-2200
Fax Number :
Provider Business Practice Location Address
First Line : 1001 GAUSE BLVD
Second Line :
City : SLIDELL
State : LA
Zip : 70458-2987
Country : US
Telephone Number : 985-280-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2020
Last Update Date : 08/10/2023

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Directions to “ DR. UNKNOWN RAFAQAT MD” Practice Location

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