Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD016925E | PA |
NPI | 1558368704 |
---|---|
Provider Name | Dr. David Mark Rafalko |
First Address | Beaver, PA 15009-3116 |
Second Address | Beaver, PA 15009-3116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2005 |
Last Update Date | 01/10/2007 |