Provider Demographics
NPI:1275822934
Name:BUB, REBECCA MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:BUB
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13402 W COAL MINE AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-5409
Mailing Address - Country:US
Mailing Address - Phone:720-828-7873
Mailing Address - Fax:720-815-0219
Practice Address - Street 1:13402 W COAL MINE AVE STE 250
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-5409
Practice Address - Country:US
Practice Address - Phone:720-828-7873
Practice Address - Fax:720-815-0219
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2019-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO51165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine