Provider Demographics
NPI:1710416250
Name:MIRANDA, RACHEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:C
Last Name:MIRANDA
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 1:319 SPRINGWOOD DR NE
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-8710
Mailing Address - Country:US
Mailing Address - Phone:828-879-8419
Mailing Address - Fax:
Practice Address - Street 1:420 N CENTER ST
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5033
Practice Address - Country:US
Practice Address - Phone:828-315-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN24245207R00000X, 390200000X
NC2021-01296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program