Provider Demographics
NPI:1295095297
Name:CHAIBAN, RAFKA (MD)
Entity type:Individual
Prefix:
First Name:RAFKA
Middle Name:
Last Name:CHAIBAN
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 1:2000 PROFESSIONAL CT STE C
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8803
Mailing Address - Country:US
Mailing Address - Phone:304-263-8853
Mailing Address - Fax:
Practice Address - Street 1:2000 PROFESSIONAL CT STE C
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8803
Practice Address - Country:US
Practice Address - Phone:304-263-8853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV26435208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVWV6228B987Medicare PIN