Provider Demographics
NPI:1346747250
Name:DURON, REBECCA MICHELLE (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELLE
Last Name:DURON
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 1:2200 W 49TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-6550
Mailing Address - Country:US
Mailing Address - Phone:605-336-6385
Mailing Address - Fax:605-336-6513
Practice Address - Street 1:2200 W 49TH ST STE 104
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-6550
Practice Address - Country:US
Practice Address - Phone:605-336-6385
Practice Address - Fax:605-336-6513
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SD15051207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program