Provider Demographics
NPI:1295362077
Name:MERRIFOX, REBECCA EMILY (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:EMILY
Last Name:MERRIFOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:MERRIAM-STELFOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-2452
Mailing Address - Country:US
Mailing Address - Phone:541-525-5285
Mailing Address - Fax:
Practice Address - Street 1:1 GENERAL WING RD
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4681
Practice Address - Country:US
Practice Address - Phone:802-773-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0.420017152208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics