Provider Demographics
NPI:1992857759
Name:RODNEY P. DONHAM, D.O.
Entity Type:Organization
Organization Name:RODNEY P. DONHAM, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-398-3868
Mailing Address - Street 1:227 UPPER PIKE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5955
Mailing Address - Country:US
Mailing Address - Phone:410-398-3868
Mailing Address - Fax:410-392-9289
Practice Address - Street 1:1881 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:RISING SUN
Practice Address - State:MD
Practice Address - Zip Code:21911-2018
Practice Address - Country:US
Practice Address - Phone:410-658-6555
Practice Address - Fax:410-392-9289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0058419207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG60874Medicare UPIN