Provider Demographics
NPI:1295836120
Name:RAFFELSON, CHERIE L S (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERIE
Middle Name:L S
Last Name:RAFFELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHERIE
Other - Middle Name:L
Other - Last Name:SHEHATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:401 KAMOKILA BLVD
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-5607
Mailing Address - Country:US
Mailing Address - Phone:808-432-3600
Mailing Address - Fax:
Practice Address - Street 1:401 KAMOKILA BLVD
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-5607
Practice Address - Country:US
Practice Address - Phone:808-432-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-12435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0246510OtherHMSA BILLING NUMBER
HI558413-06Medicaid
HIH101023Medicare PIN
HI558413-06Medicaid