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Rafaela Toniolo Wesley

Hospitalist

Allopathic & Osteopathic Physicians

450 Northside Cherokee Blvd, Canton, GA 30115-8015

PECOS Enrollment

This provider is enrolled in PECOS as RAFAELA WESLEY.

Based on the most recent information from CMS, provider Rafaela Toniolo Wesley is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1306282710
Provider Type
Individual
Full Name
Wesley, Rafaela Toniolo
Credential
D.O.

Gender
Female
Sole Proprietor
No
Enumeration Date
5/14/2013
Last Updated
1/10/2020

Contact Information

Practice Location

450 Northside Cherokee Blvd, Canton, GA 30115-8015

(770) 224-1000

(770) 224-2451

Mailing Location

Northside Hospital - Managed Care Department, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342

(404) 851-8097

(404) 250-8010

Provider Taxonomies

Code	Description	License
Code 208M00000X Primary	Description Hospitalist Allopathic & Osteopathic Physicians	License 75712 Georgia
Code 207R00000X	Description Internal Medicine Allopathic & Osteopathic Physicians	License 75712 Georgia

Rafaela Toniolo Wesley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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