Provider Demographics
NPI:1982206322
Name:ABANKWAH, KWASI OSEI
Entity Type:Individual
Prefix:
First Name:KWASI
Middle Name:OSEI
Last Name:ABANKWAH
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 1:2524 HOLLY SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-1968
Mailing Address - Country:US
Mailing Address - Phone:410-203-1341
Mailing Address - Fax:
Practice Address - Street 1:2524 HOLLY SPRINGS CT
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-1968
Practice Address - Country:US
Practice Address - Phone:410-203-1341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty