Provider Demographics
NPI:1295027977
Name:BIALAS, REBECCA WERTMAN (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:WERTMAN
Last Name:BIALAS
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 1:7920 ACC BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-8744
Mailing Address - Country:US
Mailing Address - Phone:919-596-9600
Mailing Address - Fax:
Practice Address - Street 1:7920 ACC BLVD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-8744
Practice Address - Country:US
Practice Address - Phone:919-596-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME123414207N00000X
NC2015-00433207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology