Healthcare Provider Details

I. General information

NPI: 1679708416
Provider Name (Legal Business Name): RACHEL A SCHLEICHERT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 01/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST MEDICINE, N3E09
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

1104 KENILWORTH DR STE 201
TOWSON MD
21204-3103
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6110
  • Fax:
Mailing address:
  • Phone: 410-328-6110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME119445
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License NumberME119445
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: