Provider Demographics
NPI:1851973457
Name:PAULL, RACHEL CORINE SAKRY (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CORINE SAKRY
Last Name:PAULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1848
Mailing Address - Fax:
Practice Address - Street 1:2001 S MERRIMAN RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-5540
Practice Address - Country:US
Practice Address - Phone:734-727-1000
Practice Address - Fax:734-727-1080
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI4301512117207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program