Provider Demographics
NPI:1518009539
Name:MOSKWINSKI, REBECCA ELAINE (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ELAINE
Last Name:MOSKWINSKI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:50555 CROCUS CT
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8901
Mailing Address - Country:US
Mailing Address - Phone:574-631-7567
Mailing Address - Fax:574-631-6047
Practice Address - Street 1:UNIVERSITY OF NOTRE DAME
Practice Address - Street 2:UNIVERSITY HEALTH SERVICES, ST. LIAM HALL
Practice Address - City:NOTRE DAME
Practice Address - State:IN
Practice Address - Zip Code:46556-5693
Practice Address - Country:US
Practice Address - Phone:574-631-7567
Practice Address - Fax:574-631-6047
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01031094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INE78961Medicare UPIN