MEDICARE: ALFRED G ASUMADU REGISTERED NURSE

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	163W00000X	Registered Nurse	RN. 345793	OH

General Provider Information

NPI Number	:	1235374679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALFRED G ASUMADU REGISTERED NURSE

Provider Business Mailing Address
First Line	:	4568 NORTHLAND SQUARE DR W
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-5812
Country	:	US
Telephone Number	:	614-806-1787
Fax Number	:

Provider Business Practice Location Address
First Line	:	4568 NORTHLAND SQUARE DR W
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-5812
Country	:	US
Telephone Number	:	614-806-1787
Fax Number	:

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/15/2008

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