| Doctor Name: | RUPAL RAWALJI |
| NPI Number: | 1275960544 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 209010215 |
| Business Practice Address: | 23 Rd Medical Group 3278 Mitchell Blvd, Building 900 Moody Afb, GA - 316990001 |
| Business Phone Number: | 2292572778 |
| Business Fax Number: | |
| Mailing Address: | 23 Rd Medical Group, 3278 Mitchell Blvd, Building 900 MOODY AFB |
| State: | GA |
| Postal Code: | 316990001 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/02/2013 |
| NPI Last Update Date: | 10/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209010215 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |