Individual
MR. SEAN MICHAEL RHODES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2280 PROVIDENT CT STE B, WARSAW, IN 46580-3284
(574) 269-9200
(574) 269-9658
Mailing address
2280 PROVIDENT CT. SUITE B, WARSAW, IN 46580
(574) 269-9200
(574) 269-9658
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
07000846
IN
213EP0504X
Public Medicine Podiatrist
07000846
IN
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
07000846
IN
213ER0200X
Radiology Podiatrist
07000846
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
07000846
IN
213ES0131X
Foot Surgery Podiatrist
07000846
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000108914
BLUE CROSS BLUE SHIELD
IN
05
—
200158810B
—
IN
Enumeration date
06/27/2005
Last updated
09/19/2008
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