Healthcare Provider Details

I. General information

NPI: 1427282631
Provider Name (Legal Business Name): OLIVIA OWUSU-BOAHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA ADJEKUM MD

II. Dates (important events)

Enumeration Date: 05/04/2009
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

34301 GRAHAM CIR
MILLSBORO DE
19966-3195
US

V. Phone/Fax

Practice location:
  • Phone: 201-281-2051
  • Fax:
Mailing address:
  • Phone: 201-281-2051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA08613500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC1-0027947
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD453358
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number25MA08613500
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0094133
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: