Individual
MARK C RAFALKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 614-9817
(317) 614-9655
Mailing address
PO BOX 7232, DEPT 165, INDIANAPOLIS, IN 46207-7232
(866) 282-7905
(317) 614-9655
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01046565
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
01046565
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200179430
—
IN
Enumeration date
11/18/2005
Last updated
04/04/2019
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