Healthcare Provider Details

I. General information

NPI: 1770933848
Provider Name (Legal Business Name): RACHELLE SAVALLI DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 KENMOOR AVE SUITE 301, PMB 92303
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

625 KENMOOR AVE SUITE 301, PMB 92303
GRAND RAPIDS MI
49546
US

V. Phone/Fax

Practice location:
  • Phone: 586-788-9986
  • Fax:
Mailing address:
  • Phone: 586-788-9986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101022495
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number89998146
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: