Provider Demographics
NPI:1548570567
Name:MAWULAWDE, KWABENA (MD)
Entity Type:Individual
Prefix:
First Name:KWABENA
Middle Name:
Last Name:MAWULAWDE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 COMMERCE PKWY
Mailing Address - Street 2:STE 201
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-4040
Mailing Address - Country:US
Mailing Address - Phone:505-841-1000
Mailing Address - Fax:505-843-2956
Practice Address - Street 1:951 COMMERCE PKWY
Practice Address - Street 2:STE 201
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-4040
Practice Address - Country:US
Practice Address - Phone:505-841-1000
Practice Address - Fax:505-843-2592
Is Sole Proprietor?:No
Enumeration Date:2010-10-08
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35059579208G00000X
GA047925208G00000X
NMMD2014-0911208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)