Healthcare Provider Details

I. General information

NPI: 1689986382
Provider Name (Legal Business Name): RACHEL KASSEL MD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2010
Last Update Date: 08/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL # 3S34
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

703 VOLKER HL
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6006
  • Fax: 314-454-4102
Mailing address:
  • Phone: 205-934-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number35313
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: