Provider Demographics
NPI:1770933848
Name:SAVALLI, RACHELLE (DO)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:
Last Name:SAVALLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1961 SOUTH TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:248-319-6210
Mailing Address - Fax:
Practice Address - Street 1:1961 SOUTH TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD TWP
Practice Address - State:MI
Practice Address - Zip Code:48302
Practice Address - Country:US
Practice Address - Phone:248-319-6210
Practice Address - Fax:248-607-6362
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-20
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022495207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine