Healthcare Provider Details
I. General information
NPI: 1497472575
Provider Name (Legal Business Name): REBECCA ANNE CUNNINGHAM MACFARLANE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/20/2022
Last Update Date: 07/09/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
DETROIT MEDICAL CENTER 4201 SAINT ANTOINE ST
DETROIT MI
48201
US
IV. Provider business mailing address
BEAUMONT HOSPITAL- ROYAL OAK, GME OFFICE 3601W THIRTEEN MILE RD
ROYAL OAK MI
48073
US
V. Phone/Fax
- Phone: 313-745-3000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 4301514813 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: