Provider Demographics
NPI:1235457615
Name:TIWAAH, MILLICENT OWUSU (DO)
Entity Type:Individual
Prefix:DR
First Name:MILLICENT
Middle Name:OWUSU
Last Name:TIWAAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:114 LT MICHAEL CLEARY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1649
Practice Address - Country:US
Practice Address - Phone:570-675-2000
Practice Address - Fax:570-675-1806
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS017197207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine