Basic Information
Provider Information
NPI: 1174501399
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STUMPF
FirstName: REBECCA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3530 PEACH ST
Address2: SUITE LL1
City: ERIE
State: PA
PostalCode: 165082768
CountryCode: US
TelephoneNumber: 8148605000
FaxNumber:  
Practice Location
Address1: 4950 BUFFALO RD
Address2:  
City: ERIE
State: PA
PostalCode: 165102304
CountryCode: US
TelephoneNumber: 8148997000
FaxNumber: 8148979737
Other Information
ProviderEnumerationDate: 01/06/2006
LastUpdateDate: 02/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XMD027408EPAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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