Provider Demographics
NPI:1871715086
Name:EBOH, RHANDA MARIE M (MD)
Entity type:Individual
Prefix:DR
First Name:RHANDA MARIE
Middle Name:M
Last Name:EBOH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RHANDA
Other - Middle Name:MARIE MENDOZA
Other - Last Name:MAGSALIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4704 E OAKLAND
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1180
Mailing Address - Country:US
Mailing Address - Phone:800-924-8140
Mailing Address - Fax:316-789-6210
Practice Address - Street 1:4723 E DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1012
Practice Address - Country:US
Practice Address - Phone:316-670-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV150522084P0800X
KS04-335172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry