Provider Demographics
NPI:1104823749
Name:RHYEE, JAMES TAE SUK (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TAE SUK
Last Name:RHYEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:TAE
Other - Middle Name:SUK
Other - Last Name:RHYEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5039 VILLA LINDE PKWY
Mailing Address - Street 2:STE 30
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3450
Mailing Address - Country:US
Mailing Address - Phone:810-732-8451
Mailing Address - Fax:810-732-8980
Practice Address - Street 1:5039 VILLA LINDE PKWY
Practice Address - Street 2:STE 30
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3450
Practice Address - Country:US
Practice Address - Phone:810-732-8451
Practice Address - Fax:810-732-8980
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJR0377812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2632697Medicaid
B45442Medicare UPIN
MI0250836Medicare PIN