MEDICARE: CALEB OWUSU

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	21118	MD

General Provider Information

NPI Number	:	1124466081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB OWUSU

Provider Business Mailing Address
First Line	:	8132 MEADOWGATE CIR
Second Line	:
City	:	GLEN BURNIE
State	:	MD
Zip	:	21060-8484
Country	:	US
Telephone Number	:	804-503-0186
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 W LEXINGTON ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-3414
Country	:	US
Telephone Number	:	410-385-3188
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2013
Last Update Date	:	03/04/2015

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Directions to “ CALEB OWUSU ” Practice Location

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