MEDICARE: DR. REZVAN RAFI M.D.

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	207RX0202X	Medical Oncology Physician	MD417884	PA

General Provider Information

NPI Number	:	1578709192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REZVAN RAFI M.D.

Provider Business Mailing Address
First Line	:	2476 MALEHORN RD
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-3306
Country	:	US
Telephone Number	:	610-458-6428
Fax Number	:

Provider Business Practice Location Address
First Line	:	2476 MALEHORN RD
Second Line	:
City	:	CHESTER SPRINGS
State	:	PA
Zip	:	19425-3306
Country	:	US
Telephone Number	:	610-458-6428
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	01/02/2009

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