Provider Demographics
NPI:1174889166
Name:ROJANO MARIN, RAFAEL ANTONIO (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:ROJANO MARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAFAEL
Other - Middle Name:ANTONIO
Other - Last Name:ROJANO-MARIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1901 TATE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1109
Mailing Address - Country:US
Mailing Address - Phone:434-200-5895
Mailing Address - Fax:434-200-7529
Practice Address - Street 1:1901 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1109
Practice Address - Country:US
Practice Address - Phone:434-200-5895
Practice Address - Fax:434-200-7529
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI65356-20207R00000X
390200000X
VA0101262645207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program