Provider Demographics
NPI:1578958153
Name:SKARET, REBECCA LAUREN (MD)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LAUREN
Last Name:SKARET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:REBECCA
Other - Middle Name:LAUREN
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:
Practice Address - Street 1:6727 PARKER FARM DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-3176
Practice Address - Country:US
Practice Address - Phone:910-343-1031
Practice Address - Fax:910-509-1364
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA162377207V00000X, 207VG0400X
NC2022-01394207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC28112610OtherDRIVER'S LICENSE