Provider Demographics
NPI:1144402785
Name:MOSTAFA RAFII MD INC
Entity Type:Organization
Organization Name:MOSTAFA RAFII MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MOSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFII
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-872-0330
Mailing Address - Street 1:340 RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1265
Mailing Address - Country:US
Mailing Address - Phone:330-872-0330
Mailing Address - Fax:330-872-7664
Practice Address - Street 1:340 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1265
Practice Address - Country:US
Practice Address - Phone:330-872-0330
Practice Address - Fax:330-872-7664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35035642207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0230593Medicaid
OH0230593Medicaid