Provider Demographics
NPI:1396859526
Name:TOMINACK, REBECCA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LOUISE
Last Name:TOMINACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7980 CLAYTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7980 CLAYTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1354
Practice Address - Country:US
Practice Address - Phone:314-772-5200
Practice Address - Fax:314-612-5740
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2J91207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology