MEDICARE: STEPHEN W REX 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	207Q00000X	Family Medicine Physician	0101051876	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CJ2302	OTHER		MEDICARE RAILROAD
4	080174443	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	289060	OTHER	VA	MDIPA OP CHOICE MAMSI
2	81660002	OTHER	VA	CAREFIRST BCBS
5	286376	OTHER	VA	ANTHEM BCBS
6	505645	OTHER	VA	NCPPO

General Provider Information

NPI Number	:	1861495871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN W REX MD

Provider Business Mailing Address
First Line	:	8101 HINSON FARM RD
Second Line	:	STE 415
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3410
Country	:	US
Telephone Number	:	703-799-9695
Fax Number	:	703-310-4314

Provider Business Practice Location Address
First Line	:	8101 HINSON FARM RD
Second Line	:	STE 415
City	:	ALEXANDRIA
State	:	VA
Zip	:	22306-3410
Country	:	US
Telephone Number	:	703-799-9695
Fax Number	:	703-310-4314

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/12/2015

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Directions to “ STEPHEN W REX MD” Practice Location

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