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Individual

RAFAEL LAO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 WILLOW ST STE 100, VINCENNES, IN 47591-1029
(812) 882-6416
(812) 882-8620
Mailing address
4225 LINCOLNSHIRE DR STE B, MOUNT VERNON, IL 62864-2157
(812) 882-6416
(812) 882-8620

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01042614A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100384200B
IN
Enumeration date
06/17/2006
Last updated
12/09/2025
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