Healthcare Provider Details

I. General information

NPI: 1164786372
Provider Name (Legal Business Name): MR. APOLLINAIRE DAGBE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2012
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14913 HYDRUS RD
SILVER SPRING MD
20906-1829
US

IV. Provider business mailing address

14913 HYDRUS RD
SILVER SPRING MD
20906-1829
US

V. Phone/Fax

Practice location:
  • Phone: 301-204-6285
  • Fax:
Mailing address:
  • Phone: 301-204-6285
  • 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: