Otu-Nyarko, Charles Godfried

Otu-Nyarko, Charles Godfried is an individual health care provider with primary practice located at 2508 Bert Kouns Loop Suite 101, Shreveport LA 71118-3133. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Gastroenterology. Allopathic & Osteopathic Physicians / Pediatric Gastroenterology is his primary health care specialty. Otu-Nyarko, Charles Godfried can be contacted via phone (318) 212-5858.

Contact Information

Primary practice address
2508 Bert Kouns Loop Suite 101 Shreveport LA 71118-3133
Phone: (318) 212-5858
Fax: (318) 212-5877
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125.052705 Illinois
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X MD.203819 Louisiana

Profile Details

NPI number 1245487404
LBN Legal business name Otu-Nyarko, Charles Godfried
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2008
Last updated May 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245487404 NPPES
Louisiana MEDICAID 2107259

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