MEDICARE: CLAUDETTE NNEMDI GBEMUDU-JATTO MD

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	207R00000X	Internal Medicine Physician	MD071505L	PA
2	208M00000X	Hospitalist Physician	MD071505L	PA

General Provider Information

NPI Number	:	1376505040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAUDETTE NNEMDI GBEMUDU-JATTO MD

Provider Business Mailing Address
First Line	:	2205 FOREST HILLS DR
Second Line	:	SUITE 12
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1001
Country	:	US
Telephone Number	:	717-327-4448
Fax Number	:	717-327-4449

Provider Business Practice Location Address
First Line	:	2205 FOREST HILLS DR
Second Line	:	SUITE 12
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1001
Country	:	US
Telephone Number	:	717-327-4448
Fax Number	:	717-327-4449

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	10/11/2013

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