Provider Demographics
NPI:1548227499
Name:RHOADS, SEAN PATRICK (PA-C)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:PATRICK
Last Name:RHOADS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUMMELSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17036-1839
Mailing Address - Country:US
Mailing Address - Phone:717-566-1100
Mailing Address - Fax:717-566-0600
Practice Address - Street 1:605 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-1839
Practice Address - Country:US
Practice Address - Phone:717-566-1100
Practice Address - Fax:717-566-0600
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052146207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA092149T9TMedicare ID - Type Unspecified
PAQ46518Medicare UPIN