Healthcare Provider Details

I. General information

NPI: 1629272331
Provider Name (Legal Business Name): ANTOINETTE DENISE RHYNES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 07/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SQUIRES PT
DUNCAN SC
29334-8867
US

IV. Provider business mailing address

1 INDEPENDENCE PT SUITE 212
GREENVILLE SC
29615-4545
US

V. Phone/Fax

Practice location:
  • Phone: 864-968-5123
  • Fax: 864-241-9256
Mailing address:
  • Phone: 864-797-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28840
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: