Provider Demographics
NPI:1912357310
Name:OSEI, SAMUEL KWAKU (MD)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:KWAKU
Last Name:OSEI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:KWAKU
Other - Middle Name:
Other - Last Name:OSEI-BONSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10506 MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-4487
Mailing Address - Country:US
Mailing Address - Phone:513-853-9000
Mailing Address - Fax:513-794-1620
Practice Address - Street 1:10506 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4487
Practice Address - Country:US
Practice Address - Phone:513-853-9000
Practice Address - Fax:513-794-1620
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315077492183500000X
MI4301110524208600000X
IL036159917208600000X
OH35.149093208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No183500000XPharmacy Service ProvidersPharmacist