Individual
REBECCA G THEOPHANOUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2301 ERWIN RD, DURHAM, NC 27705-4699
(919) 684-8111
Mailing address
2301 ERWIN RD, DURHAM, NC 27705-4699
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2018-00757
NC
Other
Enumeration date
04/04/2015
Last updated
04/02/2024
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