Provider Demographics
NPI:1710938428
Name:RHINESS, DEBRA LYN (MD)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LYN
Last Name:RHINESS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LYN
Other - Last Name:SCHWIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:200 PATEWOOD DR STE A120
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-6305
Practice Address - Country:US
Practice Address - Phone:864-454-2670
Practice Address - Fax:864-454-2679
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18911208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC576007863103OtherBLUECHOICE HEALTHPLAN ID
SC189110Medicaid
SC576007863102OtherBCBS OF SC ID
SC576007863102OtherBCBS OF SC ID
SCG921397951Medicare PIN
SCG921393640Medicare PIN