Provider Demographics
NPI:1740208529
Name:RHOADS, MARK D (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:RHOADS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:11510 GEORGIA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1925
Mailing Address - Country:US
Mailing Address - Phone:301-946-5100
Mailing Address - Fax:301-929-0348
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:301-946-5100
Practice Address - Fax:301-929-0348
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCDO30824207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC200132OtherKAISER
VA5705070Medicaid
DC2495234OtherAETNA HMO
DC441054OtherANTHEM BCBS
DC501347OtherNCPPO
DC0088OtherCAREFIRST BCBS
DC7675059OtherAETNA NON NMO
F30175Medicare UPIN
DC200132OtherKAISER