Individual
DR. RAFFAELE PENNELLA
Active
Individual
DR. RAFFAELE PENNELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
110288
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156123001
—
AR
05
—
208269902
—
MO
01
—
31905
MO BLUE SHIELD
MO
01
—
81292
ARK BLUE SHIELD
AR
Enumeration date
02/05/2007
Last updated
12/08/2016
Update your record
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