Provider Demographics
NPI:1992780993
Name:RHEE, M DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:M DAVID
Middle Name:
Last Name:RHEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MYUNGWOO
Other - Middle Name:DAVID
Other - Last Name:RHEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:838 W NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365
Mailing Address - Country:US
Mailing Address - Phone:937-498-9633
Mailing Address - Fax:937-493-9925
Practice Address - Street 1:838 W NORTH STREET
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365
Practice Address - Country:US
Practice Address - Phone:937-498-9633
Practice Address - Fax:937-493-9925
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-13
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36335207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0248735Medicaid
OH0248735Medicaid
OHRH0421892Medicare PIN