Provider Demographics
NPI:1205058252
Name:DALEY-PLACIDE, RACQUEL (MD)
Entity type:Individual
Prefix:
First Name:RACQUEL
Middle Name:
Last Name:DALEY-PLACIDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 S MAIN ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-5513
Mailing Address - Country:US
Mailing Address - Phone:866-949-0108
Mailing Address - Fax:
Practice Address - Street 1:525 N TRYON ST STE 1600
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-0213
Practice Address - Country:US
Practice Address - Phone:866-949-0108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500027207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine