Provider Demographics
NPI:1508878885
Name:CUEVAS, RACHEL SUSAN (MD)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:SUSAN
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:RACHEL
Other - Middle Name:SUSAN
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2480 S WOODWORTH LOOP STE 150
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:AK
Mailing Address - Zip Code:99645-7408
Mailing Address - Country:US
Mailing Address - Phone:907-861-6312
Mailing Address - Fax:907-861-6322
Practice Address - Street 1:2480 S WOODWORTH LOOP STE 150
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:AK
Practice Address - Zip Code:99645-7408
Practice Address - Country:US
Practice Address - Phone:907-861-6312
Practice Address - Fax:907-861-6322
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18000207Q00000X
AK7733207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00284536Medicaid
AK1579999Medicaid
AK1579999Medicaid
MS080004028Medicare PIN