Provider Demographics
NPI:1033296389
Name:SOWARDS, RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:SOWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 BRENTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143-1169
Mailing Address - Country:US
Mailing Address - Phone:843-469-9536
Mailing Address - Fax:
Practice Address - Street 1:301 GREAT TEAYS BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560-9552
Practice Address - Country:US
Practice Address - Phone:304-757-6999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24152207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810018227Medicaid
9471571OtherAETNA
WVWV2650DMedicare PIN
9471571OtherAETNA
WV3810018227Medicaid
WVWV2650CMedicare PIN
WV2033681Medicare PIN