Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | SP025068 | PA |
N | 207VG0400X | Gynecologist | SP025068 | PA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | SP025068 | PA |
N | 207VX0000X | Obstetrician | SP025068 | PA |
NPI | 1336808534 |
---|---|
Provider Name | Rebecca Ann Michael |
First Address | Erie, PA 16504-3012 |
Second Address | Erie, PA 16507-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2021 |
Last Update Date | 15/12/2021 |