Provider Demographics
NPI:1861613044
Name:SIMONSEN, REBECCA VIA (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:VIA
Last Name:SIMONSEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5445 MERIDIAN MARKS RD NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4763
Mailing Address - Country:US
Mailing Address - Phone:404-252-5196
Mailing Address - Fax:404-252-2414
Practice Address - Street 1:5445 MERIDIAN MARKS RD NE
Practice Address - Street 2:SUITE 350
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4763
Practice Address - Country:US
Practice Address - Phone:404-252-5196
Practice Address - Fax:404-252-2414
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2008-06-30
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Provider Licenses
StateLicense IDTaxonomies
GA061164207V00000X
TNMD0000041343207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology