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NPI Code Detail

MEDICARE: GLORY EKELEOSEYE ODIGIE

MEDICARE: GLORY EKELEOSEYE ODIGIE
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
1363L00000XNurse PractitionerR215670MD
2363LP2300XPrimary Care Nurse PractitionerR215670MD

General Provider Information

NPI Number : 1740823434
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORY EKELEOSEYE ODIGIE
Provider Business Mailing Address
First Line : 157 BALTIMORE ST STE 100
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2472
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Provider Business Practice Location Address
First Line : 157 BALTIMORE ST STE 100
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2472
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2019
Last Update Date : 02/25/2026

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Directions to “ GLORY EKELEOSEYE ODIGIE ” Practice Location

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