Provider Demographics
NPI:1134364342
Name:RACHAL, FUNMILAYO CARTER (MD)
Entity type:Individual
Prefix:
First Name:FUNMILAYO
Middle Name:CARTER
Last Name:RACHAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1718 PEACHTREE ST NW
Mailing Address - Street 2:SUITE 265
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2452
Mailing Address - Country:US
Mailing Address - Phone:404-254-3508
Mailing Address - Fax:404-254-3847
Practice Address - Street 1:1718 PEACHTREE ST NW
Practice Address - Street 2:SUITE 265
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2452
Practice Address - Country:US
Practice Address - Phone:404-254-3508
Practice Address - Fax:404-254-3847
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN92822084P0800X
GA0654892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry