Provider Demographics
NPI:1801090907
Name:SHEMTOV, RACHEL CHAYA (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CHAYA
Last Name:SHEMTOV
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 1:2301 US HIGHWAY 74 W
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-7554
Mailing Address - Country:US
Mailing Address - Phone:704-994-4500
Mailing Address - Fax:704-994-4501
Practice Address - Street 1:2301 US HIGHWAY 74 W
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-7554
Practice Address - Country:US
Practice Address - Phone:704-994-4600
Practice Address - Fax:704-994-4501
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00572207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907584Medicaid
SCN0057IMedicaid
SCN0057IOtherSOUTH CAROLINA MEDICAID
NC2071374Medicare PIN