Individual
DR. JACQUELINE AKUA OWUSU
Active
Individual
DR. JACQUELINE AKUA OWUSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
055870
GA
207R00000X
Internal Medicine Physician
Primary
055870
GA
208M00000X
Hospitalist Physician
055870
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05390548
AMERIGROUP
GA
01
—
055870
GA STATE LICENSE
GA
01
—
11674408
CAQH
GA
01
—
1539774
WELLCARE
GA
05
—
280803795A
—
GA
05
—
280803795J
—
GA
01
—
GRP4787
MEDICARE PTAN HOSPITALIST OF DUBLIN
GA
Enumeration date
11/17/2006
Last updated
12/16/2021
Update your record
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