Individual
REBECCA D VASILION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-0922
(505) 563-6380
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5483
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A-1333-05
NM
207VX0000X
Obstetrics Physician
A-1333-05
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45650241
—
NM
Enumeration date
10/04/2006
Last updated
08/25/2016
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