Healthcare Provider Details

I. General information

NPI: 1194284232
Provider Name (Legal Business Name): RACHEL ANNE DANDAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33080 UTICA RD STE B
FRASER MI
48026-2038
US

IV. Provider business mailing address

33080 UTICA RD STE B
FRASER MI
48026-2038
US

V. Phone/Fax

Practice location:
  • Phone: 586-296-7250
  • Fax: 586-944-2315
Mailing address:
  • Phone: 586-296-7250
  • Fax: 586-944-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number036.164368
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301511105
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: