Healthcare Provider Details

I. General information

NPI: 1134377435
Provider Name (Legal Business Name): DAVID K RHINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 HOLLYWOOD RD STE 110
SAINT JOSEPH MI
49085-9151
US

IV. Provider business mailing address

3950 HOLLYWOOD RD STE 110
SAINT JOSEPH MI
49085-9151
US

V. Phone/Fax

Practice location:
  • Phone: 269-985-1000
  • Fax: 269-983-3181
Mailing address:
  • Phone: 269-985-1000
  • Fax: 269-983-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number036114561
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036114561
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number6361179
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number5315052548
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: