Provider Demographics
NPI:1679599096
Name:AGUIAR, RAFAELA M (MD)
Entity Type:Individual
Prefix:
First Name:RAFAELA
Middle Name:M
Last Name:AGUIAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5826 SAMET DR STE 101
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-3661
Mailing Address - Country:US
Mailing Address - Phone:336-878-6540
Mailing Address - Fax:336-878-6541
Practice Address - Street 1:5826 SAMET DR STE 101
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-3661
Practice Address - Country:US
Practice Address - Phone:336-878-6540
Practice Address - Fax:336-878-6541
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC96-01144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891075VMedicaid
080122380OtherRR MEDICARE
NC1212660012OtherDME
CB8658OtherRR GROUP
2246301AMedicare PIN
CB8658OtherRR GROUP
G57245Medicare UPIN