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NPI 1275700254

NPI 1275700254 : REARABILOE SEBATA M.D. : LAFAYETTE, IN

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General NPI Number Information
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    NPI Number           |    1275700254
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    Entity Type          |    Individual 
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    Provider Name        |    REARABILOE SEBATA M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/09/2008
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    Last Update Date     |    02/24/2021
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Provider Practice Location Address
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    Address Line         |    5177 MCCARTY LN 
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    City                 |    LAFAYETTE
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    State                |    IN
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    Zip                  |    47905-8764
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    Country              |    US
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    Telephone            |    765-448-8000
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    Fax                  |    765-838-6302
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Provider Business Mailing Address
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    Address Line         |    1200 W WHITE RIVER BLVD 
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    City                 |    MUNCIE
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    State                |    IN
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    Zip                  |    47303-4988
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    Country              |    US
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    Telephone            |    877-668-5621
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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        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    TP105470
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    License Number State |    MN
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Taxonomy #2
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    Taxonomy Code        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    01078855A
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    License Number State |    IN
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