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NPI Code Detail

MEDICARE: DR. REBEKAH SQUIRES PHD

MEDICARE: DR. REBEKAH SQUIRES PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist7581NC
2231H00000XAudiologist3876SC
3231H00000XAudiologistA-0452WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073785226
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBEKAH SQUIRES PHD
Provider Business Mailing Address
First Line : 6035 FAIRVIEW RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3256
Country : US
Telephone Number : 704-295-3300
Fax Number : 704-838-8494
Provider Business Practice Location Address
First Line : 4421 STUART ANDREW BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28217-1589
Country : US
Telephone Number : 980-343-6960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 04/20/2026

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