Healthcare Provider Details

I. General information

NPI: 1730048208
Provider Name (Legal Business Name): DORISBRIDGE AGU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 REISTERSTOWN RD STE 165R
BALTIMORE MD
21208-1387
US

IV. Provider business mailing address

5308 85TH AVE
NEW CARROLLTON MD
20784-3247
US

V. Phone/Fax

Practice location:
  • Phone: 410-541-1316
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: