Provider Demographics
NPI:1578901625
Name:TOROSYAN, RAFAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:TOROSYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 WORNALL RD STE 208
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-5964
Mailing Address - Country:US
Mailing Address - Phone:816-531-0552
Mailing Address - Fax:816-756-2503
Practice Address - Street 1:4320 WORNALL RD STE 208
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5964
Practice Address - Country:US
Practice Address - Phone:816-531-0552
Practice Address - Fax:816-756-2503
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019022596207RN0300X
KS04-39135207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2019022596OtherMO LICENSE NUMBER