Provider Demographics
NPI:1598027070
Name:STEIN, REBECCA SUE (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:SUE
Other - Last Name:HEFEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4480 UTICA RIDGE RD
Mailing Address - Street 2:STE 1140
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1656
Mailing Address - Country:US
Mailing Address - Phone:563-742-5700
Mailing Address - Fax:
Practice Address - Street 1:4480 UTICA RIDGE RD
Practice Address - Street 2:STE 1140
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1656
Practice Address - Country:US
Practice Address - Phone:563-742-5700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-43467207V00000X
MO2012017694207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2012017694OtherMISSOURI LICENSE NUMBER
IAMD-43467OtherIOWA MEDICAL LICENSE