Provider Demographics
NPI:1679067334
Name:RUIZ GAVIRIA, RAFAEL EDUARDO SR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:EDUARDO
Last Name:RUIZ GAVIRIA
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:640 S. STATE STREET
Mailing Address - Street 2:MAIL CODE 3055
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:302-480-1688
Mailing Address - Fax:302-480-9807
Practice Address - Street 1:101 WELLNESS WAY STE 200
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-4394
Practice Address - Country:US
Practice Address - Phone:302-430-0867
Practice Address - Fax:302-430-0421
Is Sole Proprietor?:No
Enumeration Date:2018-06-17
Last Update Date:2023-07-17
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0025866207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine