Individual
DR. RACHANA SURA FOFARIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051
Mailing address
2406 BLUE RIDGE RD, SUITE 100, RALEIGH, NC 27607-6678
(919) 786-5001
(919) 786-5051
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2011-01721
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2011-01721
LICENSE NUMBER
NC
Enumeration date
04/17/2008
Last updated
07/22/2014
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