Healthcare Provider Details

I. General information

NPI: 1780738971
Provider Name (Legal Business Name): PAUL S. RHODES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 R ST NW
WASHINGTON DC
20009-1015
US

IV. Provider business mailing address

220 I ST NE STE 290
WASHINGTON DC
20002
US

V. Phone/Fax

Practice location:
  • Phone: 202-683-4340
  • Fax: 202-269-7389
Mailing address:
  • Phone: 202-683-4340
  • Fax: 202-269-7389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD14167
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: