Individual
REBECCA M BRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1915 LAKE AVE, PLYMOUTH, IN 46563-9366
(574) 948-4000
(574) 948-5454
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 335-8700
(574) 335-0760
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02002952A
IN
207Q00000X
Family Medicine Physician
229933
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000939766
BCBS LSC
IN
01
—
000000939769
BCBS MCFP
IN
01
—
000000939770
BCBS PFIM
IN
01
—
000000939771
BCBS MCPEDS
IN
05
—
200824340
—
IN
Enumeration date
08/22/2006
Last updated
07/05/2022
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