Healthcare Provider Details

I. General information

NPI: 1851973457
Provider Name (Legal Business Name): RACHEL CORINE SAKRY PAULL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26650 EUREKA RD STE C&E
TAYLOR MI
48180-4835
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 734-941-4991
  • Fax: 734-941-4919
Mailing address:
  • Phone: 947-522-1848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301512117
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: