Individual
REBECCA E SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
10 NEW DRIFTWAY, SUITE 103, SCITUATE, MA 02066-4530
(781) 545-9285
(781) 545-9553
Mailing address
PO BOX 352, SCITUATE, MA 02066-0352
(781) 545-9285
(781) 545-9553
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
2048
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000644
NEIGHBORHOOD HEALTH PLANS
MA
01
—
002048
TUFTS
MA
05
—
0357871
—
MA
01
—
2316054
AETNA
MA
01
—
2700098
UNITED HEALTH CARE
MA
01
—
333403
PILGRIM
MA
01
—
480018778
RAILROAD MEDICARE
MA
01
—
B2081900
CIGNA
MA
01
—
Y71003
B/S
MA
Enumeration date
08/15/2005
Last updated
05/08/2008
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