Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01063968A | IN |
Y | 111NI0900X | Internist | 01063968A | IN |
N | 207RH0002X | Hospice and Palliative Medicine | 01063968A | IN |
NPI | 1144493370 |
---|---|
Provider Name | Dr. Rafael David Rosario |
First Address | Indianapolis, IN 46202 |
Second Address | Indianapolis, IN 46202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 05/01/2021 |