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General NPI Number Information
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NPI Number | 1376648519
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Entity Type | Individual
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Provider Name | RAINIER RAKHAR PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 3506 W TYVOLA RD
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City | CHARLOTTE
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State | NC
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Zip | 28208-7201
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Country | US
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Telephone | 704-329-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 738 CHAUCER CIR
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City | FORT MILL
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State | SC
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Zip | 29708-6590
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Country | US
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Telephone | 786-261-8725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9102501
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License Number State | FL
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