MEDICARE: RACHEL L ONDEK PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	085005520	IL
2	363A00000X	Physician Assistant	085-005520	IL
3	363A00000X	Physician Assistant	0010-10964	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0010-10964	OTHER	NC	STATE MEDICAL LICENSE

General Provider Information

NPI Number	:	1003299637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL L ONDEK PA-C

Provider Business Mailing Address
First Line	:	PO BOX 960191
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28296-6191
Country	:	US
Telephone Number	:	770-962-3462
Fax Number	:	770-962-3463

Provider Business Practice Location Address
First Line	:	515 LAUCHWOOD DR
Second Line	:
City	:	LAURINBURG
State	:	NC
Zip	:	28352-5502
Country	:	US
Telephone Number	:	770-962-3462
Fax Number	:	770-962-3463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	05/19/2026

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