MEDICARE: DANIEL RHOADS MD

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	207ZC0006X	Clinical Pathology Physician	MT201992	PA
2	207ZC0006X	Clinical Pathology Physician	MD453351	PA
3	207ZC0006X	Clinical Pathology Physician	57.025832	OH
4	207ZC0006X	Clinical Pathology Physician	35.127960	OH

General Provider Information

NPI Number	:	1386033561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL RHOADS MD

Provider Business Mailing Address
First Line	:	11100 EUCLID AVE
Second Line	:	MAILSTOP: PTH 5077
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1716
Country	:	US
Telephone Number	:	216-844-5223
Fax Number	:	216-844-5414

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0001
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:	216-444-7612

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

Provider Enumeration Date	:	01/12/2015
Last Update Date	:	08/04/2016

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