Provider Demographics
NPI:1104093558
Name:SANTOS, REBECCA ALKIRE (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ALKIRE
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:ALKIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:525K E MARKET ST # 173
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4113
Mailing Address - Country:US
Mailing Address - Phone:704-591-7196
Mailing Address - Fax:
Practice Address - Street 1:525K E MARKET ST # 173
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4113
Practice Address - Country:US
Practice Address - Phone:704-591-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200801065208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1104093558Medicaid
NCNCK3260386Medicare PIN
NC1104093558Medicaid
NCNCK326DMedicare PIN
NCNCK326CMedicare PIN
NCNCK326EMedicare PIN
NCNCK326BMedicare PIN