MEDICARE: RUBEN WINKLER RHOADES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	MD454989	PA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207R00000X	Internal Medicine Physician	MD454989	PA

General Provider Information

NPI Number	:	1093072944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBEN WINKLER RHOADES MD

Provider Business Mailing Address
First Line	:	833 CHESTNUT ST
Second Line	:	SUITE 701
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4414
Country	:	US
Telephone Number	:	215-955-6180
Fax Number	:	215-955-6410

Provider Business Practice Location Address
First Line	:	1015 CHESTNUT ST STE 1321
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107-4313
Country	:	US
Telephone Number	:	215-955-4730
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2012
Last Update Date	:	06/20/2019

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