MEDICARE: REBECCA SCHILLING RDMS, RVT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471V0105X	Vascular Sonography Radiologic Technologist
2	246XC2903X	Vascular Specialist/Technologist Cardiovascular	44030

General Provider Information

NPI Number	:	1326538299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA SCHILLING RDMS, RVT

Provider Business Mailing Address
First Line	:	9903 DECATUR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21220-3778
Country	:	US
Telephone Number	:	443-504-9605
Fax Number	:

Provider Business Practice Location Address
First Line	:	9903 DECATUR RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21220-3778
Country	:	US
Telephone Number	:	443-504-9605
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2018
Last Update Date	:	06/16/2018

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