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Individual

MR. BRUCE CORWYN RAFFEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 LANTANA RD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5620
Mailing address
100 LANTANA RD, SUITE 202, CROSSVILLE, TN 38555-1903
(931) 484-5141
(931) 484-5620

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD17817
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3029560
TN
01
4081698
BLUE CROSS
TN
01
P00157378
RAILROAD MEDICARE
Enumeration date
08/11/2006
Last updated
12/08/2009
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