Provider Demographics
NPI:1912096702
Name:RAHAL, PEGGY (MD)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:RAHAL
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:30117 SCHOENHERR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-6854
Mailing Address - Country:US
Mailing Address - Phone:586-751-8844
Mailing Address - Fax:586-751-8596
Practice Address - Street 1:30117 SCHOENHERR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-6854
Practice Address - Country:US
Practice Address - Phone:586-751-8844
Practice Address - Fax:586-751-8596
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2021-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101272778207RP1001X
MI4301076056207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN81840011Medicare PIN