Provider Demographics
NPI:1952510729
Name:MACWAR, RACHID RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:RACHID
Middle Name:RYAN
Last Name:MACWAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHID
Other - Middle Name:
Other - Last Name:LAKHDAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1370 E VENICE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-9083
Mailing Address - Country:US
Mailing Address - Phone:941-412-0026
Mailing Address - Fax:941-412-0027
Practice Address - Street 1:1370 E VENICE AVE STE 102
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-9083
Practice Address - Country:US
Practice Address - Phone:941-412-0026
Practice Address - Fax:941-412-0027
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086793207R00000X
TXP0088207RC0000X
IL036128441207RC0000X
FLME128347207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine