Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 0101269529 | VA |
NPI | 1043638505 |
---|---|
Provider Name | Kwadwo Adu Owusu-Akyaw |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Henrico, VA 23294-4222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 21/01/2021 |