Individual
BRIAN M RABON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-5678
(843) 234-4567
Mailing address
140 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-5678
(843) 234-4567
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22576
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4121
—
SC
Enumeration date
10/10/2005
Last updated
09/05/2012
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