MEDICARE: EVELYN OWUSU MA

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942552021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVELYN OWUSU MA

Provider Business Mailing Address
First Line	:	1925 S YORK ST
Second Line	:	#101
City	:	DENVER
State	:	CO
Zip	:	80210-4245
Country	:	US
Telephone Number	:	303-504-7820
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 S. YORK ST
Second Line	:	#101
City	:	DENVER
State	:	CO
Zip	:	80210-4245
Country	:	US
Telephone Number	:	303-504-7820
Fax Number	:

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

Provider Enumeration Date	:	10/12/2012
Last Update Date	:	10/12/2012

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Directions to “ EVELYN OWUSU MA” Practice Location

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