MEDICARE: ION OCCUPATIONAL MEDICAL CONSULTANTS

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	2083X0100X	Occupational Medicine Physician

General Provider Information

NPI Number	:	1467092486
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ION OCCUPATIONAL MEDICAL CONSULTANTS

Provider Business Mailing Address
First Line	:	518 S CAMP MEADE RD
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2766
Country	:	US
Telephone Number	:	443-351-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	518 S CAMP MEADE RD
Second Line	:
City	:	LINTHICUM HEIGHTS
State	:	MD
Zip	:	21090-2766
Country	:	US
Telephone Number	:	443-351-4888
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	IFEANYI NWANESHIUDU
Credential	:	MD
Telephone Number	:	443-351-4888

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	01/07/2020

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