Provider Demographics
NPI:1770583957
Name:MORALES, RAFAEL ANGEL (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANGEL
Last Name:MORALES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:717 STATE STREET
Mailing Address - Street 2:SUITE 16, LL REGIONAL HEALTH SERVICES
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1360
Mailing Address - Country:US
Mailing Address - Phone:814-877-7100
Mailing Address - Fax:814-877-2939
Practice Address - Street 1:HAMOT FACULTY SPECIALIST- INTENSIVIST
Practice Address - Street 2:201 STATE STREET
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0000
Practice Address - Country:US
Practice Address - Phone:814-877-6000
Practice Address - Fax:814-877-3622
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD032984E207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA140987Medicare PIN
C29506Medicare UPIN