Provider Demographics
NPI:1720262009
Name:LEHRHAUPT, SIPPORA MICHELLE (PA-C)
Entity Type:Individual
Prefix:
First Name:SIPPORA
Middle Name:MICHELLE
Last Name:LEHRHAUPT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SIPPORA
Other - Middle Name:MICHELLE
Other - Last Name:WEISSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15825 SHADY GROVE RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4008
Mailing Address - Country:US
Mailing Address - Phone:301-869-9776
Mailing Address - Fax:301-216-2592
Practice Address - Street 1:15825 SHADY GROVE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4008
Practice Address - Country:US
Practice Address - Phone:301-869-9776
Practice Address - Fax:301-216-2592
Is Sole Proprietor?:No
Enumeration Date:2007-12-22
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant