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General NPI Number Information
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NPI Number | 1609815059
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Entity Type | Individual
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Provider Name | ELLEN I. RABUN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 6103 ALBEMARLE LANE
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City | BLACKSBURG
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State | VA
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Zip | 24060-3351
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Country | US
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Telephone | 540-951-9444
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Fax | 540-951-3270
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Provider Business Mailing Address
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Address Line | 6103 ALBEMARLE LN
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City | BLACKSBURG
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State | VA
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Zip | 24060-8116
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Country | US
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Telephone | 540-951-9444
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Fax | 540-951-3270
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0101055151
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License Number State | VA
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