Healthcare Provider Details

I. General information

NPI: 1417368515
Provider Name (Legal Business Name): AGNES DOEYO ASIEDU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AGNES DOEYO SISA M.D.

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE. ML7018
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE. ML7018
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-517-2234
  • Fax: 513-636-3549
Mailing address:
  • Phone: 513-517-2234
  • Fax: 513-636-3549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.132175
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.132175
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: