Provider Demographics
NPI:1124085246
Name:TAPPOUNI, RAFEL (MD)
Entity type:Individual
Prefix:
First Name:RAFEL
Middle Name:
Last Name:TAPPOUNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAFEL
Other - Middle Name:F RAPHAEL
Other - Last Name:TAPPOUNI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 198441
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-8441
Mailing Address - Country:US
Mailing Address - Phone:813-745-7365
Mailing Address - Fax:813-449-8618
Practice Address - Street 1:1796 RIDGE OAKS DR
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27310-8714
Practice Address - Country:US
Practice Address - Phone:813-745-7365
Practice Address - Fax:813-449-8618
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4275722085R0202X
FLME1297002085R0202X
NC2012-001662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ0016QOtherSC MEDICAID
NC1124085246Medicaid
NC276988OtherMEDCOST
NC7985796OtherAETNA
NC1124085246OtherTRICARE
NC2603716OtherUHC
NC185FNOtherBCBS
VA1124085246OtherVIRGINIA MEDICAID
NCP01333821OtherRAILROAD MEDICARE
SCQ0016QOtherSC MEDICAID