Individual
MARY ELIZABETH RODES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
725 UNIVERSITY BLVD, BEAVERCREEK, OH 45324-2640
(937) 245-7200
(866) 644-1883
Mailing address
431 MONTERAY AVE, OAKWOOD, OH 45419-2654
(937) 604-9136
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
88956
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2766378
—
OH
01
—
311248312
PRACTICE TAX ID #
OH
01
—
311352092
PRACTICE TAX ID #
OH
Enumeration date
05/13/2007
Last updated
03/07/2023
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