Healthcare Provider Details

I. General information

NPI: 1679276802
Provider Name (Legal Business Name): REBEKAH LYNN MARCH FARIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2252 N MONROE ST
MONROE MI
48162-4254
US

IV. Provider business mailing address

2252 N MONROE ST
MONROE MI
48162-4254
US

V. Phone/Fax

Practice location:
  • Phone: 734-682-5434
  • Fax: 734-244-5184
Mailing address:
  • Phone: 734-682-5434
  • Fax: 734-244-5184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901400606
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number5901400606
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: