Provider Demographics
NPI:1285696716
Name:TORRES, RAFAEL GUILLERMO (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:GUILLERMO
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3840 ED DR STE 105
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8097
Mailing Address - Country:US
Mailing Address - Phone:919-789-8857
Mailing Address - Fax:919-789-8858
Practice Address - Street 1:303 GREEN ST E
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4105
Practice Address - Country:US
Practice Address - Phone:252-243-9800
Practice Address - Fax:252-243-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2013-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0099-1342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891239QMedicaid
NC891239QMedicaid
H07764Medicare UPIN