Provider Demographics
NPI:1710094792
Name:CESPEDES, RICHARD DUANE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:DUANE
Last Name:CESPEDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 ELKRIDGE LANDING RD FL 2
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2924
Mailing Address - Country:US
Mailing Address - Phone:410-820-0560
Mailing Address - Fax:
Practice Address - Street 1:490 CADMUS LN STE 104
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4091
Practice Address - Country:US
Practice Address - Phone:410-820-0560
Practice Address - Fax:410-820-0564
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD68205208800000X
TXJ7928208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417330900Medicaid
TX134456602Medicaid
TX8109K1Medicare PIN
MD152940ZAM2Medicare PIN
TX134456602Medicaid