MEDICARE: DR. REBECA M PLANK 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	207R00000X	Internal Medicine Physician	219230	MA
2	207RI0200X	Infectious Disease Physician	219230	MA

General Provider Information

NPI Number	:	1598738973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REBECA M PLANK MD

Provider Business Mailing Address
First Line	:	111 CYPRESS ST
Second Line	:	BRIGHAM AND WOMEN'S PHYSICIAN ORGANIZATION
City	:	BROOKLINE
State	:	MA
Zip	:	02445-6002
Country	:	US
Telephone Number	:	617-525-8621
Fax Number	:	617-582-1222

Provider Business Practice Location Address
First Line	:	15 FRANCIS ST
Second Line	:	BRIGHAM AND WOMEN'S HOSPITAL
City	:	BOSTON
State	:	MA
Zip	:	02115-6105
Country	:	US
Telephone Number	:	617-732-8881
Fax Number	:	617-732-6829

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	12/03/2008

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