Provider Demographics
NPI:1992960934
Name:RAFFOUL, FATIMA G (MD)
Entity type:Individual
Prefix:MRS
First Name:FATIMA
Middle Name:G
Last Name:RAFFOUL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FATIMA
Other - Middle Name:
Other - Last Name:AVENDANA GUERRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 6730
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6730
Mailing Address - Country:US
Mailing Address - Phone:480-821-3600
Mailing Address - Fax:480-857-2667
Practice Address - Street 1:8410 W THOMAS RD
Practice Address - Street 2:SUITE 134
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3329
Practice Address - Country:US
Practice Address - Phone:623-907-2377
Practice Address - Fax:480-821-3610
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ45696207V00000X, 207V00000X
TXBP10030969390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ718944Medicaid