Individual
RAFIF GHADBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-4010
(314) 977-3495
Mailing address
1008 S SPRING AVE STE 3819, SAINT LOUIS, MO 63110-2520
(314) 977-4010
(314) 977-3495
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008018041
MO
207W00000X
Ophthalmology Physician
Primary
2013030530
MO
207W00000X
Ophthalmology Physician
55623
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
08/25/2008
Last updated
01/19/2021
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