Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101249223 | VA |
NPI | 1053436923 |
---|---|
Provider Name | Rebin Thomas Titus |
First Address | Roanoke, VA 24014-1010 |
Second Address | Roanoke, VA 24014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 03/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053436923 | (05) | VA |
1053436923 | ANTHEM (01) | VA |
1053436923 | GATEWAY HEALTH ALLIANCE (01) | VA |
1053436923 | HEALTHNET FEDERAL SERVICES / TRICARE (01) | VA |
1053436923 | UNITED HEALTHCARE / MAMSI (01) | VA |
5917782 | (05) | NC |
5998251 | CIGNA (01) | VA |