Provider Demographics
NPI:1558649939
Name:OWUSU, GODWIN K
Entity Type:Individual
Prefix:
First Name:GODWIN
Middle Name:K
Last Name:OWUSU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3379 THORNAPPLE CIR N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6109
Mailing Address - Country:US
Mailing Address - Phone:614-353-2434
Mailing Address - Fax:
Practice Address - Street 1:3379 THORNAPPLE CIR N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6109
Practice Address - Country:US
Practice Address - Phone:614-353-2434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH135598164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse