Individual
REBECCA LEAH MANEVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 VALERO WAY, ARDMORE, OK 73401-1615
(580) 221-6690
(210) 479-2010
Mailing address
1 VALERO WAY, ARDMORE, OK 73401-1615
(580) 221-6690
(210) 479-2010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13788
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002210B
—
OK
Enumeration date
01/23/2006
Last updated
10/08/2021
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