Provider Demographics
NPI:1770909608
Name:RHEAM, DOUGLAS PATRICK (DO)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:PATRICK
Last Name:RHEAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WHITE HORSE PIKE STE 112
Mailing Address - Street 2:
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1938
Mailing Address - Country:US
Mailing Address - Phone:856-547-0539
Mailing Address - Fax:
Practice Address - Street 1:210 W ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1715
Practice Address - Country:US
Practice Address - Phone:856-546-3003
Practice Address - Fax:856-547-5337
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA332948207RC0000X, 207RI0011X
390200000X
NJ25MB10264200207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program