Healthcare Provider Details

I. General information

NPI: 1821665753
Provider Name (Legal Business Name): REBECCA ERIN WINGFIELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N. WOLFE STREET PATHOLOGY 401
BALTIMORE MD
21287
US

IV. Provider business mailing address

600 N. WOLFE STREET PATHOLOGY 401
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3980
  • Fax:
Mailing address:
  • Phone: 410-955-3980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number61246
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: