Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | E10000197 | DE |
N | 213EP1101X | Primary Podiatric Medicine | SC005846 | PA |
Y | 213ES0103X | Foot & Ankle Surgery | E10000197 | DE |
N | 213ES0103X | Foot & Ankle Surgery | SC005846 | PA |
NPI | 1023346335 |
---|---|
Provider Name | Dr. Heather M Rafal |
First Address | Wilmington, DE 19803-2589 |
Second Address | Wilmington, DE 19808-4084 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2009 |
Last Update Date | 29/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E10000197 | LICENSE NUMBER (01) | DE |