Individual
ELLEN I. RABUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6103 ALBEMARLE LANE, BLACKSBURG, VA 24060-3351
(540) 951-9444
(540) 951-3270
Mailing address
6103 ALBEMARLE LN, BLACKSBURG, VA 24060-8116
(540) 951-9444
(540) 951-3270
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101055151
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005628971
—
VA
01
—
219203
ANTHEM
VA
01
—
219204
ANTHEM
VA
Enumeration date
06/04/2006
Last updated
09/30/2008
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