Provider Demographics
NPI:1194014308
Name:LOPEZ RHODES, MARIANNE R (MD)
Entity type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:R
Last Name:LOPEZ RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:R
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:573-499-4400
Mailing Address - Fax:573-815-6634
Practice Address - Street 1:900 W NIFONG STE 101
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3032
Practice Address - Country:US
Practice Address - Phone:573-499-4400
Practice Address - Fax:573-815-6634
Is Sole Proprietor?:No
Enumeration Date:2011-03-29
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014025210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine