Provider Demographics
NPI:1376512905
Name:RHOADES, JOHN D (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:RHOADES
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:625 E NICOLLET BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-6734
Mailing Address - Country:US
Mailing Address - Phone:952-435-0303
Mailing Address - Fax:952-892-5166
Practice Address - Street 1:625 E NICOLLET BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-6734
Practice Address - Country:US
Practice Address - Phone:952-435-0303
Practice Address - Fax:952-892-5166
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-02-11
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Provider Licenses
StateLicense IDTaxonomies
MN21858207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
56584RHOtherBCBS OF MN
A01131Medicare UPIN
MN0862640001Medicare NSC