Provider Demographics
NPI:1851803159
Name:HELMIG, REBEKAH SUEZANN
Entity Type:Individual
Prefix:
First Name:REBEKAH
Middle Name:SUEZANN
Last Name:HELMIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 CARDWELL ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MO
Mailing Address - Zip Code:63077-1094
Mailing Address - Country:US
Mailing Address - Phone:636-629-3300
Mailing Address - Fax:636-629-7377
Practice Address - Street 1:1001 CARDWELL ST
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR
Practice Address - State:MO
Practice Address - Zip Code:63077-1094
Practice Address - Country:US
Practice Address - Phone:636-629-3300
Practice Address - Fax:636-629-7377
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-27
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017022243207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine