Healthcare Provider Details

I. General information

NPI: 1124467238
Provider Name (Legal Business Name): RACHEL DIANNA MAREE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 LENOX POINTE NE
ATLANTA GA
30324-3169
US

IV. Provider business mailing address

36 LENOX POINTE NE
ATLANTA GA
30324-3169
US

V. Phone/Fax

Practice location:
  • Phone: 404-504-8891
  • Fax: 404-504-8892
Mailing address:
  • Phone: 404-504-8891
  • Fax: 404-504-8892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number78441
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: