Provider Demographics
NPI:1457506743
Name:ABI RAFEH, NIDAL (MD)
Entity Type:Individual
Prefix:DR
First Name:NIDAL
Middle Name:
Last Name:ABI RAFEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2668
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-2668
Mailing Address - Country:US
Mailing Address - Phone:985-230-7350
Mailing Address - Fax:985-230-7351
Practice Address - Street 1:15813 PAUL VEGA MD DR STE 403
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1426
Practice Address - Country:US
Practice Address - Phone:985-230-7350
Practice Address - Fax:985-230-7351
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.205221207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease