Individual
GIFTY ADUTWUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1120 POLARIS PKWY, COLUMBUS, OH 43240-4042
(614) 847-1120
Mailing address
5400 FRANTZ RD STE 250, DUBLIN, OH 43016-6102
(419) 520-2495
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004086
OH
363AM0700X
Medical Physician Assistant
004086
OH
363AS0400X
Surgical Physician Assistant
004086
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112235
—
OH
Enumeration date
10/03/2014
Last updated
12/15/2021
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