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Individual

DR. RAFI THOMAS KEVORKIAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
522 N NEW BALLAS RD STE 317, SAINT LOUIS, MO 63141-6840
(636) 634-5865
(636) 688-8317
Mailing address
522 N NEW BALLAS RD STE 317, SAINT LOUIS, MO 63141-6840
(636) 634-5865

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
108134
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
205037823
MO
01
P00413101
RR MEDICARE
MO
Enumeration date
05/23/2006
Last updated
10/14/2015
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