Provider Demographics
NPI:1932106986
Name:BONSU, BEMA KWADWO (MD)
Entity Type:Individual
Prefix:
First Name:BEMA
Middle Name:KWADWO
Last Name:BONSU
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 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-4579
Mailing Address - Fax:614-722-4565
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-4579
Practice Address - Fax:614-722-4565
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350757882080P0204X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2127184Medicaid
KY64069594Medicaid
WV2002858000Medicaid
OHB00587421Medicare ID - Type Unspecified
H01103Medicare UPIN