Provider Demographics
NPI:1063945723
Name:MCDOUGLE, REBECCA MAY (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MAY
Last Name:MCDOUGLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MAY
Other - Last Name:SALMONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11475 ROBINSON DR NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-3746
Mailing Address - Country:US
Mailing Address - Phone:763-587-9000
Mailing Address - Fax:763-587-9130
Practice Address - Street 1:11475 ROBINSON DR NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-3746
Practice Address - Country:US
Practice Address - Phone:763-587-9000
Practice Address - Fax:763-587-9130
Is Sole Proprietor?:No
Enumeration Date:2017-04-09
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN68270207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine