Provider Demographics
NPI:1538471271
Name:KONDOKWI, SAHR EDWARD (STNA)
Entity Type:Individual
Prefix:MR
First Name:SAHR
Middle Name:EDWARD
Last Name:KONDOKWI
Suffix:
Gender:M
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6291 SUNDERLAND DRIVE
Mailing Address - Street 2:APT. C
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229
Mailing Address - Country:US
Mailing Address - Phone:614-515-0721
Mailing Address - Fax:
Practice Address - Street 1:6291 SUNDERLAND DRIVE
Practice Address - Street 2:APT. C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229
Practice Address - Country:US
Practice Address - Phone:614-515-0721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH325121940704376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide