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General NPI Number Information
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NPI Number | 1770781353
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Entity Type | Individual
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Provider Name | PREETI REBECCA JOHN M.D., MPH
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 10 NORTH GREENE STREET BALTIMORE VA MEDICAL CENTER, 5C-125 (SURGERY)
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City | BALTIMORE
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State | MD
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Zip | 21201
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Country | US
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Telephone | 410-605-7233
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Fax | 410-605-7919
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Provider Business Mailing Address
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Address Line | 2515 BOSTON ST # 306
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City | BALTIMORE
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State | MD
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Zip | 21224-4739
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Country | US
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Telephone | 973-735-3212
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0067254
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | D0067254
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | D0067254
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License Number State | MD
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