Provider Information for 1558332833
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Dr. YAW ADJEI OWUSU-ADDO MD
Sex: Male
NPI: 1558332833
Last Updated: 2020-08-20
Certification Date: 2020-08-20
Certification Date: 2020-08-20
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1558332833 | ||||||||||||||||
| Enumeration Date | 2006-01-27 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 640 SUMMIT CROSSING PL STE 240 GASTONIA, NC 28054-2138 United States Phone: 704-865-0626 | Fax:704-865-6531 | ||||||||||||||||
| Primary Practice Address | 640 SUMMIT CROSSING PL STE 204 GASTONIA, NC 28054-2138 United States Phone: 704-865-0626 | Fax:704-865-6531 | ||||||||||||||||
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