Provider Demographics
NPI:1164087920
Name:SAPPA, RITA DOTTIE (NCMA)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:DOTTIE
Last Name:SAPPA
Suffix:
Gender:F
Credentials:NCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-2626
Mailing Address - Country:US
Mailing Address - Phone:907-729-6550
Mailing Address - Fax:
Practice Address - Street 1:4446 REKA DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3661
Practice Address - Country:US
Practice Address - Phone:907-229-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK514836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine