Provider Demographics
NPI:1114980869
Name:HUYETT MEAD, REBECCA F (DO)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:F
Last Name:HUYETT MEAD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:F
Other - Last Name:HUYETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:649 N LEWIS RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-1234
Mailing Address - Country:US
Mailing Address - Phone:610-495-8101
Mailing Address - Fax:610-495-8106
Practice Address - Street 1:649 N LEWIS RD
Practice Address - Street 2:SUITE 130
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-1234
Practice Address - Country:US
Practice Address - Phone:610-495-8101
Practice Address - Fax:610-495-8106
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010355-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH47022Medicare UPIN
PA050592Medicare PIN
PAH47022Medicare UPIN