Provider Demographics
NPI:1073874905
Name:RHADANS, MATTHEW DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DAVID
Last Name:RHADANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3401 PINE ST
Mailing Address - Street 2:
Mailing Address - City:HIGGINSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64037-1877
Mailing Address - Country:US
Mailing Address - Phone:660-584-2192
Mailing Address - Fax:660-584-3771
Practice Address - Street 1:3401 PINE ST
Practice Address - Street 2:
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1877
Practice Address - Country:US
Practice Address - Phone:660-584-2192
Practice Address - Fax:660-584-3771
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014025015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine