Provider Demographics
NPI:1174936124
Name:MILLER, REBECCA MARIE-RAUB (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE-RAUB
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MARIE
Other - Last Name:RAUB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:707 N ALVERNON WAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1827
Mailing Address - Country:US
Mailing Address - Phone:520-694-1614
Mailing Address - Fax:520-694-1428
Practice Address - Street 1:710 N BEAVER ST BLDG 6
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3148
Practice Address - Country:US
Practice Address - Phone:928-527-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-07
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR74644207Q00000X
AZ53211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine