Provider Demographics
NPI:1548531262
Name:IGBINEDION, STELLA OSATOHANMWEN
Entity type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:OSATOHANMWEN
Last Name:IGBINEDION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 FLETCHERS WAY
Mailing Address - Street 2:
Mailing Address - City:POINT OF ROCKS
Mailing Address - State:MD
Mailing Address - Zip Code:21777-2076
Mailing Address - Country:US
Mailing Address - Phone:443-710-5598
Mailing Address - Fax:
Practice Address - Street 1:1633 FLETCHERS WAY
Practice Address - Street 2:
Practice Address - City:POINT OF ROCKS
Practice Address - State:MD
Practice Address - Zip Code:21777-2076
Practice Address - Country:US
Practice Address - Phone:443-710-5598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies