Provider Demographics
NPI:1619923471
Name:PAUL-KAGIRI, RACHELLE (MD)
Entity Type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:PAUL-KAGIRI
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 1:10 FARRELL KIRK LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:INCIRLIK AIR BASE
Practice Address - Street 2:
Practice Address - City:ADANA
Practice Address - State:ADANA
Practice Address - Zip Code:09824-5185
Practice Address - Country:TR
Practice Address - Phone:312-676-3403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC020735207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC207350Medicaid
SC207350Medicaid