Provider Demographics
NPI:1023134442
Name:RHODES, ROBERT L (MPA, CO)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:RHODES
Suffix:
Gender:M
Credentials:MPA, CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 WOODCREEK CIR
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1178
Mailing Address - Country:US
Mailing Address - Phone:734-355-6282
Mailing Address - Fax:
Practice Address - Street 1:2883 HAWKS RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1318
Practice Address - Country:US
Practice Address - Phone:734-434-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI510H113070OtherBLUE CROSS PIN