Basic Information
| Provider Information | |||||||||
| NPI: | 1285696716 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORRES | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | GUILLERMO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3840 ED DR STE 105 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276128097 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197898857 | ||||||||
| FaxNumber: | 9197898858 | ||||||||
| Practice Location | |||||||||
| Address1: | 303 GREEN ST E | ||||||||
| Address2: | |||||||||
| City: | WILSON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278934105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2522439800 | ||||||||
| FaxNumber: | 2522439888 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2006 | ||||||||
| LastUpdateDate: | 04/16/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0099-1342 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 891239Q | 05 | NC | MEDICAID |