MEDICARE: MEGHAN MADURA M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	07173	MD

General Provider Information

NPI Number	:	1114321569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN MADURA M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	3228 TOONE ST
Second Line	:	APARTMENT #2
City	:	BALTIMORE
State	:	MD
Zip	:	21224-5042
Country	:	US
Telephone Number	:	908-963-5377
Fax Number	:

Provider Business Practice Location Address
First Line	:	2931 E BIDDLE ST
Second Line	:	PATIENT ACCOUNTING
City	:	BALTIMORE
State	:	MD
Zip	:	21213-3939
Country	:	US
Telephone Number	:	443-923-1872
Fax Number	:

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

Provider Enumeration Date	:	10/14/2014
Last Update Date	:	11/06/2015

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Directions to “ MEGHAN MADURA M.S., CCC-SLP” Practice Location

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