Individual provider Active NPI

Raed Raydan Dakdouk, PA

  • Emergency Medical Services (Emergency Medicine) Physician
  • Elyria, OH
National Provider Identifier
1720985773
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
50.010566RX Issued in OH
Practice address
630 E River St
Elyria, OH 44035-5902
Phone
(216) 937-5405
NPI assigned
Oct 22, 2026
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 50.010566RX OH Primary

Addresses

Primary practice location

630 E River St
Elyria, OH 44035-5902

Mailing address

104 N Carpenter Rd
Brunswick, OH 44212-1318
Phone (216) 937-5405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1792627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1720985773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 N CARPENTER RD",
            "city": "BRUNSWICK",
            "state": "OH",
            "postal_code": "442121318",
            "telephone_number": "216-937-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E RIVER ST",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440355902",
            "telephone_number": "216-937-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKDOUK",
        "first_name": "RAED",
        "middle_name": "RAYDAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "OH",
            "license": "50.010566RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.