Basic Information
Provider Information
NPI: 1124058003
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TONUZI
FirstName: RACQUEL
MiddleName: MARIE
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1701 WESTCHESTER DRIVE
Address2: SUITE 850
City: HIGH POINT
State: NC
PostalCode: 272627254
CountryCode: US
TelephoneNumber: 3368022400
FaxNumber: 3368022001
Practice Location
Address1: 1814 WESTCHESTER DR
Address2: SUITE 301
City: HIGH POINT
State: NC
PostalCode: 272627010
CountryCode: US
TelephoneNumber: 3368022025
FaxNumber: 3368022026
Other Information
ProviderEnumerationDate: 07/04/2006
LastUpdateDate: 07/07/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X2005-01557NCY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
590195305NC MEDICAID
P0034718801NCRR MEDICAREOTHER


Home