Provider Demographics
NPI:1619121472
Name:REBELE, BARBARA S (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:S
Last Name:REBELE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 PLEASANT HILL RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 S MARKET ST
Practice Address - Street 2:SUITE 6D
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5570
Practice Address - Country:US
Practice Address - Phone:301-682-5683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0001906363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical