MEDICARE: REBECCA F HUYETT MEAD D.O

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
1	207Q00000X	Family Medicine Physician	OS010355-L	PA

General Provider Information

NPI Number	:	1114980869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA F HUYETT MEAD D.O

Provider Business Mailing Address
First Line	:	649 N LEWIS RD
Second Line	:	SUITE 130
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1234
Country	:	US
Telephone Number	:	610-495-8101
Fax Number	:	610-495-8106

Provider Business Practice Location Address
First Line	:	649 N LEWIS RD
Second Line	:	SUITE 130
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1234
Country	:	US
Telephone Number	:	610-495-8101
Fax Number	:	610-495-8106

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	12/12/2016

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