Individual provider · NPI-1

Ingrid J Rachesky, M.D.

Pediatrics, Adolescent Medicine · Panama City, FL

NPI number1154415610
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1154415610
Entity type
Individual (NPI-1)
Name
Ingrid J Rachesky
Credential
M.D.
Sex
Female
Sole proprietor
Yes
Enumeration date
Oct 2, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2080A0000X Pediatrics, Adolescent MedicineME0044063FLYes

Practice location

2550 Jenks Ave
Panama City, FL 32405

Phone 850-769-1481 · Fax 850-763-2435

Mailing address

2550 Jenks Ave
Panama City, FL 32405

Phone 850-769-1481 · Fax 850-763-2435

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