Provider Demographics
NPI:1043208358
Name:RHEM, MARCUS (MD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:RHEM
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 1:850 W NORTH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3196
Mailing Address - Country:US
Mailing Address - Phone:877-852-8463
Mailing Address - Fax:517-817-0144
Practice Address - Street 1:1515 LAKE LANSING RD
Practice Address - Street 2:SUITE H
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3753
Practice Address - Country:US
Practice Address - Phone:800-551-7347
Practice Address - Fax:517-487-1331
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067380207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
180027029OtherRAILROAD MEDICARE
MI180H149970OtherBCBSM
MI180F373640OtherBCBSM
MI180C846310OtherBCBSM
MI3250446Medicaid
MIC84631016Medicare ID - Type Unspecified
MI180C846310OtherBCBSM
MI3250446Medicaid