Provider Demographics
NPI:1912455957
Name:OWUSU, PATRICIA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:OWUSU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:ZINIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4504 LYONS RUN CIR
Mailing Address - Street 2:APT 304
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-6382
Mailing Address - Country:US
Mailing Address - Phone:410-598-4054
Mailing Address - Fax:
Practice Address - Street 1:4504 LYONS RUN CIR
Practice Address - Street 2:APT 304
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-6382
Practice Address - Country:US
Practice Address - Phone:410-598-4054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16469183500000X
DEA1-0004534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist