Healthcare Provider Details

I. General information

NPI: 1699462838
Provider Name (Legal Business Name): YEHONADAV KADOSH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GREENE ST # 5A-119A
BALTIMORE MD
21201-1524
US

IV. Provider business mailing address

10 N GREENE ST # 5A-119A
BALTIMORE MD
21201-1524
US

V. Phone/Fax

Practice location:
  • Phone: 703-342-8763
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number01827
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: