MEDICARE: DR. TAEKHYUN RHEE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		ZZ

General Provider Information

NPI Number	:	1093121626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAEKHYUN RHEE

Provider Business Mailing Address
First Line	:	701 25TH AVE S STE 400
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1443
Country	:	US
Telephone Number	:	612-659-4900
Fax Number	:	612-659-4901

Provider Business Practice Location Address
First Line	:	701 25TH AVE S STE 400
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55454-1443
Country	:	US
Telephone Number	:	612-659-4900
Fax Number	:	612-659-4901

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2014
Last Update Date	:	07/05/2015

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