Individual
DR. LEONA ODEMENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
100 BRAMBLE ST, CAMBRIDGE, MD 21613-2471
(443) 225-6640
(443) 225-6641
Mailing address
100 BRAMBLE ST, CAMBRIDGE, MD 21613-2471
(443) 225-6640
(443) 225-6641
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
01443
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172837
MEDICARE TPAN
MD
01
—
5849300001
DURABLE MEDICAL EQUIPMENT (DME) PTAN
MD
Enumeration date
09/15/2006
Last updated
09/21/2012
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