Provider Demographics
NPI:1619065984
Name:MENSAH, G TETTEH (MD)
Entity Type:Individual
Prefix:DR
First Name:G
Middle Name:TETTEH
Last Name:MENSAH
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 1:4357 FERGUSON DR
Mailing Address - Street 2:SUITE #210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-1689
Mailing Address - Country:US
Mailing Address - Phone:513-732-0100
Mailing Address - Fax:513-732-9006
Practice Address - Street 1:4357 FERGUSON DR
Practice Address - Street 2:SUITE #210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-1689
Practice Address - Country:US
Practice Address - Phone:513-732-0100
Practice Address - Fax:513-732-9006
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-060107207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0861607Medicaid
OH160058486OtherRAILROAD MEDICARE
OH0861607Medicaid
OH0836703Medicare PIN