Provider Demographics
NPI:1811379852
Name:MACIAS, RACHEL JO (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:JO
Last Name:MACIAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:REHLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 E DOUGLAS RD STE 108
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-1464
Mailing Address - Country:US
Mailing Address - Phone:574-968-9100
Mailing Address - Fax:
Practice Address - Street 1:611 E DOUGLAS RD STE 108
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1464
Practice Address - Country:US
Practice Address - Phone:616-391-6243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107699208200000X
IN01086489A208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery