Provider Demographics
NPI:1396206777
Name:MARTIN, REBECCA BREESE (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:BREESE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:OLIVE
Other - Last Name:BREESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2651 CENTENNIAL CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1303
Mailing Address - Country:US
Mailing Address - Phone:919-368-0341
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW STE 206
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2993
Practice Address - Country:US
Practice Address - Phone:202-877-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program