Provider Demographics
NPI:1174556542
Name:RHEAUME, MAKI KURAOKA (MD)
Entity type:Individual
Prefix:DR
First Name:MAKI
Middle Name:KURAOKA
Last Name:RHEAUME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 POWERS FERRY RD. SE
Mailing Address - Street 2:BUILDING 30, SUITE 100
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:770-980-0000
Mailing Address - Fax:770-217-4164
Practice Address - Street 1:1640 POWERS FERRY RD.
Practice Address - Street 2:BLDG.30,SUITE 100
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:770-980-0000
Practice Address - Fax:770-217-4164
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056473207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine