Individual
SYED S RAFIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180
Mailing address
333 HIGHWAY 82 W, GREENWOOD, MS 38930-6538
(662) 453-3167
(662) 453-9180
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14648
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00116022
—
MS
01
—
P01276395
RAILROAD MEDICARE PTAN
MS
Enumeration date
08/18/2006
Last updated
08/21/2014
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