Healthcare Provider Details

I. General information

NPI: 1750694360
Provider Name (Legal Business Name): REBECCA M. KWAIT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA M. WIGHT M.D.

II. Dates (important events)

Enumeration Date: 07/24/2010
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ALUMNI DR STE 201
EXETER NH
03833-2122
US

IV. Provider business mailing address

7 HOLLAND WAY FL 1
EXETER NH
03833-2997
US

V. Phone/Fax

Practice location:
  • Phone: 603-775-7405
  • Fax: 603-775-7424
Mailing address:
  • Phone: 603-775-7405
  • Fax: 603-775-7424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17518
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number289976
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: