Provider Demographics
NPI:1245658707
Name:BUERBA SILLER, RAFAEL ANTONIO (MD/MHS)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:BUERBA SILLER
Suffix:
Gender:M
Credentials:MD/MHS
Other - Prefix:DR
Other - First Name:RAFAEL
Other - Middle Name:ANTONIO
Other - Last Name:BUERBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD/MHS
Mailing Address - Street 1:9165 W THUNDERBIRD RD
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4847
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9165 W THUNDERBIRD RD
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4847
Practice Address - Country:US
Practice Address - Phone:412-432-3662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ61668207X00000X, 207XX0005X
CAA141060207X00000X
PAMT217914207XX0005X
CT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program