Provider Demographics
NPI:1518931872
Name:ALSTON, REBECCA B (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:B
Last Name:ALSTON
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 1:7024 GUNLOCK RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7241
Mailing Address - Country:US
Mailing Address - Phone:757-240-5180
Mailing Address - Fax:
Practice Address - Street 1:7024 GUNLOCK RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-7241
Practice Address - Country:US
Practice Address - Phone:757-240-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035534207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1518931872Medicaid
FL265788100Medicaid
FL265788100Medicaid
D80384Medicare UPIN
010338P23Medicare PIN