Individual
GREGORY RACHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7220 W NATIONAL AVE, WEST ALLIS, WI 53214-4734
(414) 257-8500
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-2288
(401) 444-5088
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57281
WI
207Q00000X
Family Medicine Physician
LP001411
RI
207Q00000X
Family Medicine Physician
MD13465
RI
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
LAJ00004
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002198101
MEDICARE PTAN
RI
05
—
1023271475
—
WI
05
—
GR85523
—
RI
Enumeration date
07/07/2008
Last updated
07/24/2017
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