Provider Demographics
NPI:1750694360
Name:KWAIT, REBECCA M (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:M
Last Name:KWAIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:M
Other - Last Name:WIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7 HOLLAND WAY FL 1
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2997
Mailing Address - Country:US
Mailing Address - Phone:603-775-7405
Mailing Address - Fax:603-775-7424
Practice Address - Street 1:3 ALUMNI DR STE 201
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833-2122
Practice Address - Country:US
Practice Address - Phone:603-775-7405
Practice Address - Fax:603-775-7424
Is Sole Proprietor?:No
Enumeration Date:2010-07-24
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2899762086X0206X
NH17518208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3104356Medicaid