Basic Information
| Provider Information | |||||||||
| NPI: | 1114023165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHYMER-ANDERSON | ||||||||
| FirstName: | DOLORES | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., FACOG, MBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10026 OLD OCEAN CITY BLVD. | ||||||||
| Address2: | BUILDING #1 | ||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218111288 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4106419450 | ||||||||
| FaxNumber: | 4106419515 | ||||||||
| Practice Location | |||||||||
| Address1: | 11107 RACETRACK ROAD | ||||||||
| Address2: | |||||||||
| City: | BERLIN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 218113279 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4102089761 | ||||||||
| FaxNumber: | 4102089764 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 08/29/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 035507 | GA | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 000509429J | 05 | GA | MEDICAID |