Healthcare Provider Details

I. General information

NPI: 1376480178
Provider Name (Legal Business Name): JOSEPH AGU OKPA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 BLACKSMITH WAY
FREDERICK MD
21702-1592
US

IV. Provider business mailing address

1630 BLACKSMITH WAY
FREDERICK MD
21702-1592
US

V. Phone/Fax

Practice location:
  • Phone: 227-278-5217
  • Fax:
Mailing address:
  • Phone: 227-278-5217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: