Healthcare Provider Details

I. General information

NPI: 1689509382
Provider Name (Legal Business Name): CHARITY BOAMAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1388 CLYDESDALE AVE
COLUMBUS OH
43229-1338
US

IV. Provider business mailing address

1388 CLYDESDALE AVE
COLUMBUS OH
43229-1338
US

V. Phone/Fax

Practice location:
  • Phone: 614-657-2319
  • Fax:
Mailing address:
  • Phone: 614-657-2319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberTB203557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: