MEDICARE: ALEXANDRA W REHFUSS 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	2088P0231X	Pediatric Urology Physician	35.132930	OH
2	208800000X	Urology Physician	35.132930	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H734780	OTHER	OH	CGS-MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1790129625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA W REHFUSS MD

Provider Business Mailing Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:	614-722-4565

Provider Business Practice Location Address
First Line	:	700 CHILDRENS DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43205-2664
Country	:	US
Telephone Number	:	614-722-6200
Fax Number	:	614-722-4565

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

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	08/28/2019

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