Individual provider Active NPI

Ephraim E Dagadu, MD

  • Family Medicine Physician
  • Cockeysville, MD
National Provider Identifier
1780773010
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D32012 Issued in MD
Practice address
9832 York Road
Suite F
Cockeysville, MD 21030-4936
Phone
(410) 628-1861
Fax
(410) 628-1862
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D32012 MD Primary

Addresses

Primary practice location

9832 York Road
Suite F
Cockeysville, MD 21030-4936

Mailing address

9832-F York Road
Cockeysville, MD 21030-4936
Phone (410) 628-1861

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171219001720 DC Practitioner - Family Practice 3870741234 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC CurrentSince Jun 1, 2012 Accepting new patients
MNR Industries LLC CurrentSince Oct 17, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Jun 1, 2012 Accepting new patients
MNR Industries, LLC Current Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC Current Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

9832 York Rd
Ste F
Cockeysville, MD 21030
Phone (410) 628-1861

9832 York Rd
#F
Cockeysville, MD 21030
Phone (410) 628-1861

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314057600000",
    "number": "1780773010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9832-F YORK ROAD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210304936",
            "telephone_number": "410-628-1861",
            "fax_number": "410-628-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9832 YORK ROAD",
            "address_2": "SUITE F",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210304936",
            "telephone_number": "410-628-1861",
            "fax_number": "410-628-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGADU",
        "first_name": "EPHRAIM",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D32012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

Verify at the official NPI Registry.