Provider Demographics
NPI:1811279771
Name:ASUMING TAWIAH, ISAAC
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:ASUMING TAWIAH
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 1:8716 GREYLAG ST
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-7028
Mailing Address - Country:US
Mailing Address - Phone:614-501-1522
Mailing Address - Fax:
Practice Address - Street 1:8716 GREYLAG ST
Practice Address - Street 2:
Practice Address - City:BLACKLICK
Practice Address - State:OH
Practice Address - Zip Code:43004-7028
Practice Address - Country:US
Practice Address - Phone:614-501-1522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.128809-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse