Provider Demographics
NPI:1063414605
Name:RAZAFINDRABE, BELL M (MD)
Entity type:Individual
Prefix:
First Name:BELL
Middle Name:M
Last Name:RAZAFINDRABE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 S PATTON RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BEND
Mailing Address - State:KS
Mailing Address - Zip Code:67530-4627
Mailing Address - Country:US
Mailing Address - Phone:620-792-2991
Mailing Address - Fax:620-792-3804
Practice Address - Street 1:925 S PATTON RD
Practice Address - Street 2:
Practice Address - City:GREAT BEND
Practice Address - State:KS
Practice Address - Zip Code:67530-4627
Practice Address - Country:US
Practice Address - Phone:620-792-2991
Practice Address - Fax:620-792-3804
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0431344208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200354350CMedicaid
KS200354350AMedicaid
KSP00290737OtherRR MEDICARE
KS200354350CMedicaid
KS144072Medicare UPIN