Provider Demographics
NPI:1316443278
Name:RAFII, SHYAUN (DPM)
Entity type:Individual
Prefix:
First Name:SHYAUN
Middle Name:
Last Name:RAFII
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9010 LORTON STATION BLVD STE 270
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4798
Mailing Address - Country:US
Mailing Address - Phone:571-418-8670
Mailing Address - Fax:
Practice Address - Street 1:9010 LORTON STATION BLVD STE 270
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4798
Practice Address - Country:US
Practice Address - Phone:571-418-8670
Practice Address - Fax:571-418-8671
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-31
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301323213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty