Healthcare Provider Details

I. General information

NPI: 1871782680
Provider Name (Legal Business Name): ARTHUR EDWARD RABENHORST MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46440 BENEDICT DRIVE SUITE 108
STERLING VA
20164
US

IV. Provider business mailing address

46440 BENEDICT DRIVE SUITE 108
STERLING VA
20164
US

V. Phone/Fax

Practice location:
  • Phone: 703-444-5656
  • Fax: 703-444-5789
Mailing address:
  • Phone: 703-444-5656
  • Fax: 703-444-5789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number0101241925
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: