Provider Demographics
NPI:1689632960
Name:REHA, WILLIAM C (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:C
Last Name:REHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2296 OPITZ BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3352
Mailing Address - Country:US
Mailing Address - Phone:703-670-5107
Mailing Address - Fax:703-670-8435
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:#220
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:703-670-5107
Practice Address - Fax:703-670-8435
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101034939208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007533390Medicaid
VA047717OtherANTHEM BCBS
MD76950001OtherCAREFIRST BCBS
VA047717OtherANTHEM BCBS
MD76950001OtherCAREFIRST BCBS