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NPI Code Detail

MEDICARE: JEANNETTE LATOYA MURDAUGH LGSW

MEDICARE:   JEANNETTE LATOYA MURDAUGH  LGSW
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
1104100000XSocial Worker22412MD

General Provider Information

NPI Number : 1649784893
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANNETTE LATOYA MURDAUGH LGSW
Provider Business Mailing Address
First Line : 7474 GREENWAY CENTER DR STE 700B
Second Line :
City : GREENBELT
State : MD
Zip : 20770-3523
Country : US
Telephone Number : 240-513-4155
Fax Number :
Provider Business Practice Location Address
First Line : 1011 N CHARLES ST
Second Line :
City : BALTIMORE
State : MD
Zip : 21201-5424
Country : US
Telephone Number : 443-436-2915
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2017
Last Update Date : 11/27/2017

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Directions to “ JEANNETTE LATOYA MURDAUGH LGSW” Practice Location

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