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Individual

DR. STANCIE C. RHODES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 SPRINGFIELD AVENUE, SUITE 3A, SUMMIT, NJ 07901
(908) 202-6942
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(908) 202-6942

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA08753400
NJ
208600000X
Surgery Physician
D0065118
MD
208600000X
Surgery Physician
MD036519
DC
208600000X
Surgery Physician
TL38211
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0237353
NJ
01
P00883890
RR MCR PTAN
NJ
01
P01117753
RAILROAD MEDICARE
NJ
Enumeration date
04/17/2007
Last updated
10/02/2015
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