Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD454989 | PA |
Y | 111NI0900X | Internist | MD454989 | PA |
N | 207RH0000X | Hematologist | MD454989 | PA |
NPI | 1093072944 |
---|---|
Provider Name | Ruben Winkler Rhoades |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 20/06/2019 |