MEDICARE: SMART OMEIMEN ESEKHAIGBE

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1578412391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SMART OMEIMEN ESEKHAIGBE

Provider Business Mailing Address
First Line	:	5434 85TH AVE APT T2
Second Line	:
City	:	NEW CARROLLTON
State	:	MD
Zip	:	20784-3117
Country	:	US
Telephone Number	:	202-413-5053
Fax Number	:

Provider Business Practice Location Address
First Line	:	1647 BENNING RD NE # 300
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4569
Country	:	US
Telephone Number	:	240-601-3699
Fax Number	:

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

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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