Provider Demographics
NPI:1750945895
Name:RONO, CHELANGAT
Entity type:Individual
Prefix:
First Name:CHELANGAT
Middle Name:
Last Name:RONO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:PRINCESS ANNE
Mailing Address - State:MD
Mailing Address - Zip Code:21853-2970
Mailing Address - Country:US
Mailing Address - Phone:410-651-4200
Mailing Address - Fax:
Practice Address - Street 1:11120 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:PRINCESS ANNE
Practice Address - State:MD
Practice Address - Zip Code:21853-2970
Practice Address - Country:US
Practice Address - Phone:410-651-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR500115005876Medicaid