Individual
MATTHEW JOHN RACHWALSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1225 E COOLSPRING AVE STE 200, MICHIGAN CITY, IN 46360-6312
(219) 861-8161
(219) 873-9504
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
02005158A
IN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
02005158A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02005158A
MD/DO LICENSE
IN
Enumeration date
03/11/2013
Last updated
09/05/2023
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