Healthcare Provider Details
I. General information
NPI: 1043740525
Provider Name (Legal Business Name): RACHID SOULEYE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/15/2017
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4650 HILLS AND DALES RD NW
CANTON OH
44708-6220
US
IV. Provider business mailing address
PO BOX 80690
CANTON OH
44708-0690
US
V. Phone/Fax
- Phone: 330-491-9675
- Fax:
- Phone: 330-363-7444
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | 34.018064 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083X0100X |
| Taxonomy | Occupational Medicine Physician |
| License Number | 04934 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: