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Individual
DR. CLINTON REBELLO
Active
Individual
DR. CLINTON REBELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207Q00000X
Family Medicine Physician
01078834A
IN
207Q00000X
Family Medicine Physician
201003
AK
207Q00000X
Family Medicine Physician
25MA11691000
NJ
207Q00000X
Family Medicine Physician
Primary
MD481798
PA
208D00000X
General Practice Physician
01078834A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
FAMILY MEDICINE
VA
Enumeration date
06/06/2015
Last updated
02/04/2025
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