Provider Demographics
NPI:1417368515
Name:ASIEDU, AGNES DOEYO (MD)
Entity Type:Individual
Prefix:DR
First Name:AGNES
Middle Name:DOEYO
Last Name:ASIEDU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AGNES
Other - Middle Name:DOEYO
Other - Last Name:SISA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3333 BURNET AVE. ML7018
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229
Mailing Address - Country:US
Mailing Address - Phone:513-517-2234
Mailing Address - Fax:513-636-3549
Practice Address - Street 1:3333 BURNET AVE. ML7018
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-517-2234
Practice Address - Fax:513-636-3549
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132175208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0377434Medicaid