Healthcare Provider Details

I. General information

NPI: 1902066715
Provider Name (Legal Business Name): SANG HO RHEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD BLDG SUITE307
BALTIMORE MD
21239-2945
US

IV. Provider business mailing address

6173 FLUTIE LN
CLARKSVILLE MD
21029-1483
US

V. Phone/Fax

Practice location:
  • Phone: 443-444-5711
  • Fax: 301-695-4469
Mailing address:
  • Phone: 267-972-7591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT190093
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD 437817
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number25MA08944800
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0078068
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: