Provider Demographics
NPI:1295055580
Name:DEATHERAGE, RACHEL CABRERA (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CABRERA
Last Name:DEATHERAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2368
Mailing Address - Country:US
Mailing Address - Phone:602-906-3740
Mailing Address - Fax:602-265-3385
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:SUITE 500
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2368
Practice Address - Country:US
Practice Address - Phone:602-906-3740
Practice Address - Fax:602-265-3385
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR72109207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine