Provider Demographics
NPI:1932671674
Name:SAPP, RHONDA MICHELLE (DOM)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:MICHELLE
Last Name:SAPP
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 HECKEL AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-6321
Mailing Address - Country:US
Mailing Address - Phone:443-570-3710
Mailing Address - Fax:
Practice Address - Street 1:4204 HECKEL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-6321
Practice Address - Country:US
Practice Address - Phone:443-570-3710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU-0901171100000X
MDU-00901171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist