Individual
MR. KEVIN F REBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
397 LITTLE NECK RD STE 120, VIRGINIA BEACH, VA 23452-5774
(757) 395-1600
(757) 961-9359
Mailing address
397 LITTLE NECK RD STE 120, VIRGINIA BEACH, VA 23452-5774
(757) 395-1600
(757) 961-9359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110840540
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014277P
SENTARA
VA
01
—
139178
BCBS
VA
05
—
1972551695
—
VA
01
—
P00387578
RR MEDICARE
VA
Enumeration date
05/05/2006
Last updated
02/17/2022
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