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Individual

RAFAEL ANGEL MIRANDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4692 BROWNSBORO RD, WINSTON SALEM, NC 27106-3410
(336) 251-1114
(336) 251-1117
Mailing address
4692 BROWNSBORO RD, WINSTON SALEM, NC 27106-3410
(336) 251-1114
(336) 251-1117

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200600373
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
143U9
BCBS
NC
01
192202
MEDCOST
05
5905104
NC
01
7139831
AETNA
01
P00367203
RAILROAD MEDICARE
Enumeration date
06/30/2006
Last updated
01/19/2017
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