Provider Demographics
NPI:1528338407
Name:T. ROBERT RHODIN M.D. LLC
Entity type:Organization
Organization Name:T. ROBERT RHODIN M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOR
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:RHODIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-784-3611
Mailing Address - Street 1:1010 MEDICAL CENTER DR STE 130
Mailing Address - Street 2:
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927-3448
Mailing Address - Country:US
Mailing Address - Phone:843-784-3611
Mailing Address - Fax:843-784-3711
Practice Address - Street 1:1010 MEDICAL CENTER DR STE 130
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927-3448
Practice Address - Country:US
Practice Address - Phone:843-784-3611
Practice Address - Fax:843-784-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-09
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17149207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A547580281Medicare PIN