Mattison, Rebecca Suzanne

Mattison, Rebecca Suzanne is an individual health care provider with primary practice located at 7701 York Ave S Suite 180, Edina MN 55435-5845. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Mattison, Rebecca Suzanne can be contacted via phone (952) 927-7810.

Contact Information

Primary practice address
7701 York Ave S Suite 180 Edina MN 55435-5845
Phone: (952) 927-7810
Fax: (952) 927-6309
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 41654 Minnesota

Profile Details

NPI number 1093775736
LBN Legal business name Mattison, Rebecca Suzanne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated May 6th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093775736 NPPES
Minnesota Other 3300159 SELECT CARE
Minnesota Other 3300003 SELECT CARE
Minnesota Other 142689C626 SELECT CARE
Minnesota Other HP33644 SELECT CARE
Minnesota Other 960541028184 SELECT CARE
Minnesota Other 1362715 SELECT CARE
Minnesota MEDICAID 279224900 SELECT CARE
Minnesota Other 3300159 SELECT CARE
Minnesota Other 256L5MA SELECT CARE
Minnesota Other 410999025 SELECT CARE

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