Provider Demographics
NPI:1235374679
Name:ASUMADU, ALFRED G (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:G
Last Name:ASUMADU
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4568 NORTHLAND SQUARE DR W
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-5812
Mailing Address - Country:US
Mailing Address - Phone:614-806-1787
Mailing Address - Fax:
Practice Address - Street 1:4568 NORTHLAND SQUARE DR W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-5812
Practice Address - Country:US
Practice Address - Phone:614-806-1787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN. 345793163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse