Healthcare Provider Details

I. General information

NPI: 1477641751
Provider Name (Legal Business Name): ALAN RAYMOND RHOADES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 S NEW HOPE RD STE 1
GASTONIA NC
28056
US

IV. Provider business mailing address

3670 S NEW HOPE RD STE 1
GASTONIA NC
28056-8597
US

V. Phone/Fax

Practice location:
  • Phone: 704-709-3239
  • Fax: 704-478-8194
Mailing address:
  • Phone: 704-709-3239
  • Fax: 704-478-8194

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number2007-00193
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2007-00193
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: