Provider Demographics
NPI:1245658582
Name:MINTZ-COLE, RACHAEL A (MD)
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:A
Last Name:MINTZ-COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:MINTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2301 ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-5954
Mailing Address - Country:US
Mailing Address - Phone:734-625-1089
Mailing Address - Fax:
Practice Address - Street 1:2301 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-5954
Practice Address - Country:US
Practice Address - Phone:734-625-1089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2020-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME140605207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program