Provider Demographics
NPI:1316947245
Name:RHEES, MARY MARGARET (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:RHEES
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:PO BOX 4699
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47903-4699
Mailing Address - Country:US
Mailing Address - Phone:765-449-2732
Mailing Address - Fax:765-449-1196
Practice Address - Street 1:1425 UNITY PL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-5756
Practice Address - Country:US
Practice Address - Phone:765-447-7460
Practice Address - Fax:765-447-8396
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN010345492085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200389380Medicaid
IN200389380Medicaid
IN815150XXXMedicare PIN
IN719710NMedicare PIN
E24165Medicare UPIN