Provider Demographics
NPI:1922162189
Name:FILLA, REBECCA DAWN (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:DAWN
Last Name:FILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:DONATELLO
Other - Last Name:FILLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2101 E JEFFERSON ST
Mailing Address - Street 2:KAISER PERMANENTE MEDICARE ENROLLMENT
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-2424
Mailing Address - Fax:
Practice Address - Street 1:2291 EVELYN BYRD AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5424
Practice Address - Country:US
Practice Address - Phone:540-564-5790
Practice Address - Fax:833-574-4981
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054856207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
006432M92Medicare ID - Type Unspecified
F92384Medicare UPIN