Provider Demographics
NPI:1053342592
Name:RABBITT, EDWARD CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CHARLES
Last Name:RABBITT
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 1:6355 WALKER LN
Mailing Address - Street 2:SUITE 501
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3245
Mailing Address - Country:US
Mailing Address - Phone:703-765-4321
Mailing Address - Fax:703-971-0958
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:SUITE 501
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-765-4321
Practice Address - Fax:703-971-0958
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0030644207X00000X
VA0101036585207X00000X
DCMD14460207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD342721800Medicaid
39689OtherMDIPA/OPT CH/MAMSI PROV#
MD200028366OtherRAILROAD MEDICARE
MD419539OtherCAREFIRST MARYLAND PROV#
DC46950005OtherCAREFIRST NCA
DC46950005OtherCAREFIRST NCA
MD419539OtherCAREFIRST MARYLAND PROV#
B93412Medicare UPIN
DC176608Medicare ID - Type UnspecifiedMEDICARE METRO GROUP #