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NPI Code Detail

MEDICARE: RACHEL CAROLAN

MEDICARE: RACHEL CAROLAN
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
1207Q00000XFamily Medicine Physician5101024913MI

General Provider Information

NPI Number : 1720440134
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHEL CAROLAN
Provider Business Mailing Address
First Line : 2333 BIDDLE AVE
Second Line :
City : WYANDOTTE
State : MI
Zip : 48192
Country : US
Telephone Number : 734-287-9029
Fax Number : 734-246-8795
Provider Business Practice Location Address
First Line : 26300 WOODWARD AVE
Second Line :
City : ROYAL OAK
State : MI
Zip : 48067-0917
Country : US
Telephone Number : 248-546-2110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2016
Last Update Date : 01/07/2020

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Directions to “ RACHEL CAROLAN ” Practice Location

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