Provider Demographics
NPI:1659692754
Name:MONROE, RACHAEL CORRITONE (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:CORRITONE
Last Name:MONROE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:229 WADSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-4510
Mailing Address - Country:US
Mailing Address - Phone:804-228-3627
Mailing Address - Fax:804-560-1312
Practice Address - Street 1:229 WADSWORTH DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4510
Practice Address - Country:US
Practice Address - Phone:804-228-3627
Practice Address - Fax:804-560-1312
Is Sole Proprietor?:No
Enumeration Date:2010-06-13
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101250773207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
540883363OtherTIN