Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 07000846 | IN |
N | 222Z00000X | Podiatrist | 07000846 | IN |
N | 213EP0504X | Public Medicine | 07000846 | IN |
Y | 213EP1101X | Primary Podiatric Medicine | 07000846 | IN |
N | 111NR0200X | Radiology | 07000846 | IN |
N | 213ER0200X | Radiology | 07000846 | IN |
N | 213ES0103X | Foot & Ankle Surgery | 07000846 | IN |
N | 213ES0131X | Foot Surgery | 07000846 | IN |
NPI | 1225034028 |
---|---|
Provider Name | Mr. Sean Michael Rhodes |
First Address | Warsaw, IN 46580 |
Second Address | Warsaw, IN 46580-3284 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 19/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000108914 | BLUE CROSS BLUE SHIELD (01) | IN |
200158810B | (05) | IN |
U68565 | (02) | IN |