Provider Demographics
NPI:1700844883
Name:WHELAN, RHONDA K (DO)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:K
Last Name:WHELAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:K
Other - Last Name:BROHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 E WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2360
Mailing Address - Country:US
Mailing Address - Phone:989-725-6101
Mailing Address - Fax:989-723-3601
Practice Address - Street 1:113 E WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2360
Practice Address - Country:US
Practice Address - Phone:989-725-6101
Practice Address - Fax:989-723-3601
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101013244207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
2057800495OtherBCBSM PIN
0990428OtherHEALTHPLUS
MI4290212Medicaid
2057800495OtherBCBSM PIN
0550210001Medicare NSC
0M0914005Medicare PIN