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1407814635

NPI Code Detail

MEDICARE: REBECCA M. DAHLBERG M.D.

MEDICARE: REBECCA M. DAHLBERG M.D.

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	207R00000X	Internal Medicine Physician	1689	WI
2	207R00000X	Internal Medicine Physician	49738	WI
3	207R00000X	Internal Medicine Physician	MD440013	PA
4	207R00000X	Internal Medicine Physician	54081	MN
5	207RN0300X	Nephrology Physician	MD440013	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	415288	OTHER	PA	UPMC-WMG
2	1591277	OTHER	PA	GATEWAY-WMG
3	2514078	OTHER	PA	HIGHMARK BLUE SHIELD-WMG
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407814635
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA M. DAHLBERG M.D.

Provider Business Mailing Address
First Line	:	2925 CHICAGO AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55407-1321
Country	:	US
Telephone Number	:	612-262-4813
Fax Number	:	612-262-4194

Provider Business Practice Location Address
First Line	:	407 W 66TH ST
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2304
Country	:	US
Telephone Number	:	612-798-8800
Fax Number	:

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	09/11/2012

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Directions to “ REBECCA M. DAHLBERG M.D.” Practice Location

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