Healthcare Provider Details

I. General information

NPI: 1609898667
Provider Name (Legal Business Name): REBECCA S SIMES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA S SIMES I MD

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 SPOTSYLVANIA PKWY SUITE 205
FREDERICKSBURG VA
22407-9435
US

IV. Provider business mailing address

PO BOX 1460
FREDERICKSBURG VA
22402-1460
US

V. Phone/Fax

Practice location:
  • Phone: 540-834-5430
  • Fax: 540-834-5431
Mailing address:
  • Phone: 540-786-2100
  • Fax: 540-786-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101102732
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: