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General NPI Number Information
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NPI Number | 1013444967
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Entity Type | Individual
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Provider Name | GINA ELIZABETH REBESCO MD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 145 MICHIGAN ST NE STE 1100
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2562
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Country | US
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Telephone | 616-486-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 625 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1900
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Country | US
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Telephone | 205-975-0222
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | LL52664
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD.38309
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License Number State | AL
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