Individual
DR. EGBERT REBEIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
143 KENNEDY DR, SUITE B, MARTIN, TN 38237-3309
(731) 587-3030
(731) 587-3032
Mailing address
143 KENNEDY DR, SUITE B, MARTIN, TN 38237-3309
(731) 587-3030
(731) 587-3032
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
24570
KY
207P00000X
Emergency Medicine Physician
E-6965
AR
208600000X
Surgery Physician
Primary
E-6965
AR
208600000X
Surgery Physician
MD 12630
TN
2086X0206X
Surgical Oncology Physician
MD-12630
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156656
BHP
TN
01
—
32638
TLC
TN
05
—
3325272
—
TN
01
—
3831541
CIGNA
TN
01
—
4082293
AETNA
TN
01
—
4092729
BCBS
TN
01
—
64771579
KY MEDICAID
KY
Enumeration date
05/11/2006
Last updated
07/30/2024
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