Provider Demographics
NPI:1184696148
Name:BIEDENBENDER, REX D (MD)
Entity type:Individual
Prefix:DR
First Name:REX
Middle Name:D
Last Name:BIEDENBENDER
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 1:4624 MISTRAL LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-5057
Mailing Address - Country:US
Mailing Address - Phone:757-303-6023
Mailing Address - Fax:757-767-7493
Practice Address - Street 1:4624 MISTRAL LN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-5057
Practice Address - Country:US
Practice Address - Phone:757-303-6023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101058925207RG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherFIRST HEALTH COMMERCIAL/SOUTHERN HEALTH/COVENTRY
VA34572OtherSENTARA/OPTIMA
VAPAROtherAETNA
VAPAROtherCORVEL/CORCARE
VA005849829Medicaid
NC063W5OtherBC/BS
VA885932OtherUHC/MAMSI
VA-022OtherTRICARE/CHAMPUS
VA382958OtherANTHEM
VAPAROtherVIRGINIA HEALTH NETWORK
NC89063W5Medicaid
VAPAROtherMULTIPLAN
VAPAROtherUSA MANAGED CARE
VAPAROtherVIRGINIA PREMIER HEALTH
VAPAROtherCIGNA
NC89063W5Medicaid
VA005849829Medicaid
VA110217899Medicare PIN
VAVV0138AMedicare PIN