Provider Demographics
NPI:1336163831
Name:PADOW, RHODA BEATRICE (M D)
Entity Type:Individual
Prefix:DR
First Name:RHODA
Middle Name:BEATRICE
Last Name:PADOW
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11348 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MD
Mailing Address - Zip Code:20759-2510
Mailing Address - Country:US
Mailing Address - Phone:301-317-6006
Mailing Address - Fax:301-604-1946
Practice Address - Street 1:11348 DUKE ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MD
Practice Address - Zip Code:20759-2510
Practice Address - Country:US
Practice Address - Phone:301-317-6006
Practice Address - Fax:301-604-1946
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00223282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6560Medicare ID - Type Unspecified
MDC88094Medicare UPIN