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Individual
ALLEN TERENCE RAPHAEL
Active
Individual
ALLEN TERENCE RAPHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD001050
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52212173-001
BC/BS, SMYRNA
GA
01
—
52212173-002
BC/BS DOUGLASVILLE
GA
01
—
5284933
CIGNA
GA
01
—
581994261
GREAT WEST HEALTHCARE
GA
05
—
761921467A
—
GA
05
—
761921467C
—
GA
05
—
761921467G
—
GA
05
—
761921467J
—
GA
05
—
761921467P
—
GA
01
—
946888
BLUE CROSS BLUE SHIELD GA
GA
Enumeration date
05/26/2006
Last updated
10/15/2018
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