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General NPI Number Information
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NPI Number | 1134193857
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Entity Type | Individual
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Provider Name | MARYELLEN RHINEHART MD
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Gender | Female
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 77 MASS AVE E23 193 MIT MEDICAL DEPARTMENT
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City | CAMBRIDGE
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State | MA
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Zip | 02139-4301
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Country | US
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Telephone | 617-253-7802
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Fax | 617-258-0419
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Provider Business Mailing Address
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Address Line | 25 CARLETON ST E23
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City | CAMBRIDGE
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State | MA
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Zip | 02142-1323
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Country | US
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Telephone | 617-253-4988
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 76897
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License Number State | MA
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