Provider Demographics
NPI:1023243813
Name:RAPHAEL, MICHELLE LOUISE (DO)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LOUISE
Last Name:RAPHAEL
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-2422
Mailing Address - Fax:970-490-4155
Practice Address - Street 1:4110 BRIARGATE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7836
Practice Address - Country:US
Practice Address - Phone:719-365-7300
Practice Address - Fax:719-365-7301
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2024-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ0065572084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology