Healthcare Provider Details

I. General information

NPI: 1639139413
Provider Name (Legal Business Name): RICHARD O. ADDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RICHARD OFFEI-ADDO MD

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8415 BELLONA LN SUITE 216
TOWSON MD
21204-2055
US

IV. Provider business mailing address

8607 TRAIL VIEW DR
ELLICOTT CITY MD
21043-6082
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-5444
  • Fax: 410-821-5515
Mailing address:
  • Phone: 410-465-1887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0059283
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: