Raphael, Allen Terence

Raphael, Allen Terence is an individual health care provider with primary practice located at 3200 Highlands Parkway Suite 100, Smyrna GA 30082-5196. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Raphael, Allen Terence can be contacted via phone (770) 319-5502.

Contact Information

Primary practice address
3200 Highlands Parkway Suite 100 Smyrna GA 30082-5196
Phone: (770) 319-5502
Fax: (770) 434-9010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD001050 Georgia

Profile Details

NPI number 1770539801
LBN Legal business name Raphael, Allen Terence
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Oct 15th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770539801 NPPES
Georgia Other 52212173-001 BC/BS, SMYRNA
Georgia MEDICAID 761921467P BC/BS, SMYRNA
Georgia MEDICAID 761921467G BC/BS, SMYRNA
Georgia Other 52212173-002 BC/BS, SMYRNA
Georgia MEDICAID 761921467A BC/BS, SMYRNA
Georgia Other 946888 BC/BS, SMYRNA
Georgia Other 5284933 BC/BS, SMYRNA
Georgia MEDICAID 761921467J BC/BS, SMYRNA
Georgia Other 581994261 BC/BS, SMYRNA
Georgia MEDICAID 761921467C BC/BS, SMYRNA

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