Provider Demographics
NPI:1891769394
Name:ARTHUR-MENSAH, THEOPHILUS (MD)
Entity Type:Individual
Prefix:
First Name:THEOPHILUS
Middle Name:
Last Name:ARTHUR-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 1:5343 MEADOW LANE CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHEFFIELD VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44035-1469
Mailing Address - Country:US
Mailing Address - Phone:440-934-2311
Mailing Address - Fax:440-988-2801
Practice Address - Street 1:5343 MEADOW LANE CT
Practice Address - Street 2:SUITE B
Practice Address - City:SHEFFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44035-1469
Practice Address - Country:US
Practice Address - Phone:440-934-2311
Practice Address - Fax:440-988-2801
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350690162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0195953Medicaid
000000183937OtherANTHEM
OH2943917Medicaid
B77478Medicare UPIN
OH9375981Medicare PIN
OH0195953Medicaid