Provider Demographics
NPI:1154459485
Name:RAPHAEL, KATE BENDON (MD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:BENDON
Last Name:RAPHAEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:BENDON
Other - Last Name:RAPHAEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2550 TENDERFOOT HILL ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-3998
Mailing Address - Country:US
Mailing Address - Phone:719-633-3400
Mailing Address - Fax:
Practice Address - Street 1:2550 TENDERFOOT HILL ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3998
Practice Address - Country:US
Practice Address - Phone:719-633-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32222207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA104733Medicare PIN