Provider Demographics
NPI:1629272331
Name:RHYNES, ANTOINETTE DENISE (MD)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:DENISE
Last Name:RHYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6306
Mailing Address - Fax:
Practice Address - Street 1:500 SQUIRES PT
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334-8867
Practice Address - Country:US
Practice Address - Phone:864-968-5123
Practice Address - Fax:864-241-9256
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571004971008OtherBCBS STATE/PREFERRED BLUE
SC288405Medicaid
SCAA39986769Medicare PIN
SC288405Medicaid