Provider Demographics
NPI:1114912631
Name:RABINE, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:RABINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 W BELVEDERE AVE STE 308
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5230
Mailing Address - Country:US
Mailing Address - Phone:410-601-5392
Mailing Address - Fax:410-601-7854
Practice Address - Street 1:2411 W BELVEDERE AVE STE 308
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:410-601-5392
Practice Address - Fax:410-601-7854
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6088207RG0100X
MDD0067157207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FY260OtherBLUE CROSS BLUE SHIELD
MD017791100Medicaid
TX361007301Medicaid
TXP01733202OtherRAILROAD MEDICARE