| Dr Daniel Ezidiegwu Jr, | |
|
1130 Annapolis Rd Ste 100, Odenton, MD 21113-1622 | |
| (410) 672-2255 | |
| (410) 672-2275 |
| Full Name | Dr Daniel Ezidiegwu Jr |
|---|---|
| Gender | Male |
| Speciality | Physical Medicine And Rehabilitation |
| Experience | 9 Years |
| Location | 1130 Annapolis Rd Ste 100, Odenton, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184159444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | H91622 (Maryland) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Greater Maryland Pain Management, Llc | 4486881513 | 12 |
| Entity Name | Greater Maryland Pain Management LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710312723 PECOS PAC ID: 4486881513 Enrollment ID: O20131218000234 |
| Entity Name | Checkerspot Surgery Centers LLC |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1447685458 PECOS PAC ID: 2860621539 Enrollment ID: O20140130000178 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Daniel Ezidiegwu Jr, 1130 Annapolis Rd Ste 100, Odenton, MD 21113-1622 Ph: (410) 672-2255 | Dr Daniel Ezidiegwu Jr, 1130 Annapolis Rd Ste 100, Odenton, MD 21113-1622 Ph: (410) 672-2255 |
Dr. Johnny Van Dang, DO Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 1130 Annapolis Rd Ste 100, Odenton, MD 21113 Phone: 410-672-2255 |
Taylor Woody, Physical Medicine & Rehabilitation Medicare: Not Enrolled in Medicare Practice Location: 1110 Town Center Blvd Ste I, Odenton, MD 21113 Phone: 410-672-8094 |