Individual
DR. REBECCA WALTERS LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19683
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01224050
—
MS
01
—
9445059
AETNA
MS
Enumeration date
03/08/2007
Last updated
07/22/2020
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