Provider Demographics
NPI:1508934290
Name:KROLL, RHONDA GISELLE (MD)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:GISELLE
Last Name:KROLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 PARK DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-7141
Mailing Address - Country:US
Mailing Address - Phone:443-812-5200
Mailing Address - Fax:207-879-3153
Practice Address - Street 1:163 CHATHAM BUSINESS DR
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9726
Practice Address - Country:US
Practice Address - Phone:919-545-7337
Practice Address - Fax:919-545-7338
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02032207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1508934290Medicaid
ME000479901Medicare PIN
ME1508934290Medicaid