Provider Demographics
NPI:1629068911
Name:PLUTE, REBECCA L (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:L
Last Name:PLUTE
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 1:1 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1301
Mailing Address - Country:US
Mailing Address - Phone:724-746-7030
Mailing Address - Fax:724-703-1650
Practice Address - Street 1:1 N CENTRAL AVE STE 400
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-1301
Practice Address - Country:US
Practice Address - Phone:724-746-7030
Practice Address - Fax:724-703-1650
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073787L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1324718OtherHIGHMARK
PA001850440Medicaid
PA001850440Medicaid
PA050256D4ZMedicare PIN