Provider Demographics
NPI:1467760389
Name:LEEANN RHODES, M.D., P.C.
Entity Type:Organization
Organization Name:LEEANN RHODES, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-8834
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-0113
Mailing Address - Country:US
Mailing Address - Phone:301-345-8834
Mailing Address - Fax:301-345-8838
Practice Address - Street 1:8824 CUNNINGHAM DR STE C
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2338
Practice Address - Country:US
Practice Address - Phone:301-345-8834
Practice Address - Fax:301-345-8838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD212981700Medicaid