Provider Demographics
NPI:1083862056
Name:GUILLOW, REBEKAH KAY (MD)
Entity type:Individual
Prefix:
First Name:REBEKAH
Middle Name:KAY
Last Name:GUILLOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBEKAH
Other - Middle Name:KAY
Other - Last Name:STROUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-1200
Mailing Address - Country:US
Mailing Address - Phone:304-598-4800
Mailing Address - Fax:
Practice Address - Street 1:930 CHESTNUT RIDGE RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-2807
Practice Address - Country:US
Practice Address - Phone:304-598-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WV24797207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP01107335OtherRAILROAD MEDICARE
WV3810023254Medicaid
WV9333201OtherMEDICARE GROUP
WV9333201OtherMEDICARE GROUP