Healthcare Provider Details

I. General information

NPI: 1659799682
Provider Name (Legal Business Name): ALISON RHOADES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 06/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 11TH ST FL 14
PHILADELPHIA PA
19107-4824
US

IV. Provider business mailing address

333 COTTMAN AVE
PHILADELPHIA PA
19111-2434
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-9937
  • Fax: 215-955-9791
Mailing address:
  • Phone: 215-955-9937
  • Fax: 215-955-9791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD460778
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: