MEDICARE: DR. REX D. BIEDENBENDER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	0101058925	VA
2	207R00000X	Internal Medicine Physician	0101058925	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PAR	OTHER	VA	FIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
2	34572	OTHER	VA	SENTARA/OPTIMA
3	PAR	OTHER	VA	AETNA
4	PAR	OTHER	VA	CORVEL/CORCARE
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	063W5	OTHER	NC	BC/BS
7	885932	OTHER	VA	UHC/MAMSI
8	-022	OTHER	VA	TRICARE/CHAMPUS
9	382958	OTHER	VA	ANTHEM
10	PAR	OTHER	VA	VIRGINIA HEALTH NETWORK
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	PAR	OTHER	VA	MULTIPLAN
13	PAR	OTHER	VA	USA MANAGED CARE
14	PAR	OTHER	VA	VIRGINIA PREMIER HEALTH
15	PAR	OTHER	VA	CIGNA

General Provider Information

NPI Number	:	1184696148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REX D. BIEDENBENDER MD

Provider Business Mailing Address
First Line	:	4624 MISTRAL LN
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5057
Country	:	US
Telephone Number	:	757-303-6023
Fax Number	:	757-767-7493

Provider Business Practice Location Address
First Line	:	4624 MISTRAL LN
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5057
Country	:	US
Telephone Number	:	757-303-6023
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	12/20/2024

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