Provider Demographics
NPI:1558368704
Name:RAFALKO, DAVID MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARK
Last Name:RAFALKO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1301 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-3116
Mailing Address - Country:US
Mailing Address - Phone:724-728-7800
Mailing Address - Fax:724-728-8115
Practice Address - Street 1:1301 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-3116
Practice Address - Country:US
Practice Address - Phone:724-728-7800
Practice Address - Fax:724-728-8115
Is Sole Proprietor?:No
Enumeration Date:2005-07-02
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD016925E207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery