Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 24570 | KY |
N | 207P00000X | Emergency Physician | E-6965 | AR |
Y | 208200000X | Surgeon | E-6965 | AR |
Y | 208600000X | Surgeon | E-6965 | AR |
N | 208200000X | Surgeon | MD 12630 | TN |
N | 208600000X | Surgeon | MD 12630 | TN |
N | 2086X0206X | Surgical Oncologist | MD-12630 | TN |
NPI | 1275583908 |
---|---|
Provider Name | Dr. Egbert Rebeiro |
First Address | Martin, TN 38237-3309 |
Second Address | Martin, TN 38237-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156656 | BHP (01) | TN |
32638 | TLC (01) | TN |
3325272 | (05) | TN |
3831541 | CIGNA (01) | TN |
4082293 | AETNA (01) | TN |
4092729 | BCBS (01) | TN |
64771579 | KY MEDICAID (01) | KY |
B03903 | (02) | TN |