Provider Demographics
NPI: | 1356309280 |
---|---|
Name: | RAPOPORT, AARON PAUL (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | AARON |
Middle Name: | PAUL |
Last Name: | RAPOPORT |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 62602 |
Mailing Address - Street 2: | |
Mailing Address - City: | BALTIMORE |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 21264-2602 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 410-328-1230 |
Mailing Address - Fax: | 410-328-1975 |
Practice Address - Street 1: | 22 S GREENE ST |
Practice Address - Street 2: | |
Practice Address - City: | BALTIMORE |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21201-1544 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-328-1230 |
Practice Address - Fax: | 410-328-1975 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-05-02 |
Last Update Date: | 2011-03-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | D52477 | 207RH0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RH0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MD | 317600200 | Medicaid | |
DC | 026612800 | Medicaid | |
MD | 546974-01 | Other | BLUE CROSS/BLUE SHIELD |
DE | 1000015029 | Medicaid | |
MD | 830005029 | Medicare PIN | |
DE | 1000015029 | Medicaid | |
DC | 026612800 | Medicaid |