MEDICARE: REBECCA C RASTETTER MD

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	208000000X	Pediatrics Physician	35.079773	OH

General Provider Information

NPI Number	:	1386725455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA C RASTETTER MD

Provider Business Mailing Address
First Line	:	703 STATE ROUTE 28
Second Line	:	SUITE B
City	:	MILFORD
State	:	OH
Zip	:	45150-5021
Country	:	US
Telephone Number	:	513-831-9912
Fax Number	:	513-965-3992

Provider Business Practice Location Address
First Line	:	703 STATE ROUTE 28
Second Line	:	SUITE B
City	:	MILFORD
State	:	OH
Zip	:	45150-5021
Country	:	US
Telephone Number	:	513-831-9912
Fax Number	:	513-965-3992

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/08/2007

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