Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 16170 | CO |
NPI | 1073515698 |
---|---|
Provider Name | Dr. Edward Allen Rhodes |
First Address | Denver, CO 80206-1109 |
Second Address | Denver, CO 80206-1109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 19/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01161702 | (05) | CO |
E06364 | (02) |