Provider Demographics
NPI:1891998662
Name:PLUMER, REBECCA LANEY (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:LANEY
Last Name:PLUMER
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 1:13736 SAND CHERRY PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-7602
Mailing Address - Country:US
Mailing Address - Phone:719-487-8884
Mailing Address - Fax:719-487-9117
Practice Address - Street 1:13736 SAND CHERRY PL
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-7602
Practice Address - Country:US
Practice Address - Phone:719-487-8884
Practice Address - Fax:719-487-9117
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3142207R00000X
CAG035383207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A92576Medicare UPIN