Provider Demographics
NPI:1023086899
Name:CAMPEN, REBECCA B (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:B
Last Name:CAMPEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5102 PAULSEN ST
Mailing Address - Street 2:BLDG 4
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4601
Mailing Address - Country:US
Mailing Address - Phone:912-356-3604
Mailing Address - Fax:912-356-5801
Practice Address - Street 1:5102 PAULSEN ST
Practice Address - Street 2:BLDG 4
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4601
Practice Address - Country:US
Practice Address - Phone:912-356-3604
Practice Address - Fax:912-356-5801
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA74873207N00000X
GA031202207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724676OtherTUFTS HEALTH PLAN
MA3093034Medicaid
MAJ12489OtherBCBS MA
MA3093034Medicaid
E16137Medicare UPIN
MA724676OtherTUFTS HEALTH PLAN