Provider Demographics
NPI:1902054620
Name:FOX, REBECCA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANNE
Last Name:FOX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5573 POCUSSET ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1912
Mailing Address - Country:US
Mailing Address - Phone:443-528-4619
Mailing Address - Fax:
Practice Address - Street 1:230 MCKEE PL
Practice Address - Street 2:SUITE 500
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3903
Practice Address - Country:US
Practice Address - Phone:412-647-8265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-06
Last Update Date:2008-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT192629207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMT192629OtherPA STATE MEDICAL TRAINEE LICENSE #