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Individual

DR. MARK PAUL RHEAUME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
960 JOE FRANK HARRIS PKWY SE, CARTERSVILLE, GA 30120-2129
(770) 607-7339
(678) 928-9759
Mailing address
PO BOX 200096, CARTERSVILLE, GA 30120-9002
(678) 928-9759
(678) 928-9759

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
054657
GA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
054657
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
137013442
GA
01
511I300172
MEDICARE ID
01
GRP1205
GROUP MEDICARE ID
GA
Enumeration date
11/07/2007
Last updated
04/14/2022
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