Provider Demographics
NPI:1497852651
Name:RHOADES, SIDNEY F (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:F
Last Name:RHOADES
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:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:
Practice Address - Street 1:129 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4949
Practice Address - Country:US
Practice Address - Phone:803-774-9680
Practice Address - Fax:803-774-5217
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29351207RH0002X
SCTL29351207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4350563OtherCIGNA
SCP00688370OtherRAIL ROAD MEDICARE
SC7336946OtherAETNA
SC293514Medicaid
SC20056155OtherFIRST CHOICE
SCI61149Medicare UPIN
SCI611497399Medicare PIN
SCP00688370OtherRAIL ROAD MEDICARE
SC20056155OtherFIRST CHOICE
SC293514Medicaid