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NPI Code Detail

MEDICARE: JEFFERSON THOMAS RABE PA-C

MEDICARE: JEFFERSON THOMAS RABE PA-C
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
1363A00000XPhysician Assistant8344GA
2363A00000XPhysician Assistant2219SC
3363A00000XPhysician Assistant008344GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518360007
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFERSON THOMAS RABE PA-C
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 888-472-0043
Fax Number : 843-724-2440
Provider Business Practice Location Address
First Line : 2093 HENRY TECKLENBURG DR STE 200E
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-5742
Country : US
Telephone Number : 843-958-2500
Fax Number : 843-958-2680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2014
Last Update Date : 04/01/2026

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