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General NPI Number Information
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NPI Number | 1346284668
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Entity Type | Organization
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Legal Business Name | ABRAHAM OWUSU-DOMMEY LLC
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 3303 S LINDSAY RD STE 123
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City | GILBERT
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State | AZ
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Zip | 85297-1503
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Country | US
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Telephone | 480-821-9339
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Fax | 480-821-9555
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Provider Business Mailing Address
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Address Line | PO BOX 2510
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City | MESA
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State | AZ
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Zip | 85214-2510
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Country | US
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Telephone | 480-821-9339
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Fax | 480-821-9555
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Authorized Official
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Title or Position | OWNER
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Name | DR. ABRAHAM OWUSU DOMMEY
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Credential | M.D.
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Telephone | 480-821-9339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 26852
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License Number State | AZ
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