Provider Demographics
NPI:1760870257
Name:BRABENDER, REBECCA ROBINSON (MD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ROBINSON
Last Name:BRABENDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40690 BLACK GOLD PL
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-7199
Mailing Address - Country:US
Mailing Address - Phone:540-668-5474
Mailing Address - Fax:
Practice Address - Street 1:40690 BLACK GOLD PL
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-7199
Practice Address - Country:US
Practice Address - Phone:540-668-5474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238003207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine