Provider Demographics
NPI:1558527291
Name:MIDDLETON, REBECCA JOANN (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOANN
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8601 VETERANS HWY
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1547
Mailing Address - Country:US
Mailing Address - Phone:410-729-4601
Mailing Address - Fax:410-729-4618
Practice Address - Street 1:8601 VETERANS HWY
Practice Address - Street 2:SUITE 111
Practice Address - City:MILLERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21108-1547
Practice Address - Country:US
Practice Address - Phone:410-729-4601
Practice Address - Fax:410-729-4618
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68017207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine