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NPI Code Detail

MEDICARE: REGINA OGBONNA PA-C

MEDICARE: REGINA OGBONNA PA-C
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
1363A00000XPhysician AssistantMD

General Provider Information

NPI Number : 1558225581
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA OGBONNA PA-C
Provider Business Mailing Address
First Line : 901 HARRY S TRUMAN DR N
Second Line :
City : LARGO
State : MD
Zip : 20774-5477
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 901 HARRY S TRUMAN DR N
Second Line :
City : LARGO
State : MD
Zip : 20774-5477
Country : US
Telephone Number : 240-677-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ REGINA OGBONNA PA-C” Practice Location

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