Provider Demographics
NPI:1497076582
Name:RAINES, REBEKAH (MD)
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:
Last Name:RAINES
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 1:5955 ZEAMER AVE
Mailing Address - Street 2:673RD MDG
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99506-3700
Mailing Address - Country:US
Mailing Address - Phone:907-580-6525
Mailing Address - Fax:
Practice Address - Street 1:5955 ZEAMER AVE
Practice Address - Street 2:673RD MDG
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506-3700
Practice Address - Country:US
Practice Address - Phone:907-580-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-12
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070633A207ZP0102X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology