Provider Demographics
NPI:1366964306
Name:OSEI-BONSU, KWABENA JR
Entity type:Individual
Prefix:
First Name:KWABENA
Middle Name:
Last Name:OSEI-BONSU
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947-1424
Mailing Address - Country:US
Mailing Address - Phone:302-855-0915
Mailing Address - Fax:302-855-0914
Practice Address - Street 1:1507 MIDDLEFORD RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3615
Practice Address - Country:US
Practice Address - Phone:302-629-4569
Practice Address - Fax:302-628-4669
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0024057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine