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General NPI Number Information
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NPI Number | 1144412412
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Entity Type | Individual
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Provider Name | SAMPSON BOADI SARPONG MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 10756 RHODE ISLAND AVE
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City | BELTSVILLE
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State | MD
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Zip | 20705-2513
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Country | US
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Telephone | 301-931-7799
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Fax | 301-931-7733
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Provider Business Mailing Address
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Address Line | 14819 KIMBERWICK DR
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City | BOWIE
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State | MD
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Zip | 20715-3347
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Country | US
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Telephone | 301-931-7799
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Fax | 301-931-7733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number | D0039249
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License Number State | MD
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