MEDICARE: MRS. STELLA OSATOHANMWEN IGBINEDION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1548531262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STELLA OSATOHANMWEN IGBINEDION

Provider Business Mailing Address
First Line	:	1633 FLETCHERS WAY
Second Line	:
City	:	POINT OF ROCKS
State	:	MD
Zip	:	21777-2076
Country	:	US
Telephone Number	:	443-710-5598
Fax Number	:

Provider Business Practice Location Address
First Line	:	1633 FLETCHERS WAY
Second Line	:
City	:	POINT OF ROCKS
State	:	MD
Zip	:	21777-2076
Country	:	US
Telephone Number	:	443-710-5598
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2012
Last Update Date	:	01/26/2012

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