Provider Demographics
NPI:1083805725
Name:RHEINBOLT, JOSHUA (MD)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:RHEINBOLT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:645 AMALIA ST NE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2434
Mailing Address - Country:US
Mailing Address - Phone:704-295-3255
Mailing Address - Fax:704-295-7791
Practice Address - Street 1:645 AMALIA ST NE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2434
Practice Address - Country:US
Practice Address - Phone:704-295-3255
Practice Address - Fax:704-295-7791
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200801881207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ0188AMedicaid
NC1524NOtherBCBSNC
NCP01683317OtherRAILROAD MEDICARE
NC1630369OtherCIGNA
SC1223904OtherWELLCARE OF SC
SC1223904OtherWELLCARE OF SC