Provider Demographics
NPI:1245694488
Name:RABIE, KEVIN DAVID (DPM)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:DAVID
Last Name:RABIE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 HOLLAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2859
Mailing Address - Country:US
Mailing Address - Phone:757-228-3735
Mailing Address - Fax:757-498-7936
Practice Address - Street 1:3720 HOLLAND RD STE 100
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2859
Practice Address - Country:US
Practice Address - Phone:757-228-3735
Practice Address - Fax:757-498-7936
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103301271213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist