Dr. Charles Godfried Otu-nyarko

M.D | Pediatric Gastroenterology | Male

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Complete Profile:

Dr. Charles Godfried Otu-nyarko basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Gastroenterology
Provider Name :	Dr. Charles Godfried Otu-nyarko
Credential :	M.D
Gender :	Male

Business Address:

Dr. Charles Godfried Otu-nyarko address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	2508 Bert Kouns Loop, Suite 101 Shreveport, LA, 71118-3133 United States
Phone Number :	318-212-5858
Fax Number :	318-212-5877

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1245487404
NPI Entity Type :	Individual
First Enrolment Date :	19 Aug, 2008
Last Updated On :	14 May, 2021

Medicare Participation:

Dr. Charles Godfried Otu-nyarko participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	3678702503
Medicare Enrollment ID :	I20140218001710
Primary Specialty :	Pediatric Medicine
Medical School :	Louisiana State University School Of Medicine In New Orleans
Graduation Year :	2013
Accepts Medicare?	Yes. Dr. Charles Godfried Otu-nyarko accepts medicare insurance.

Group Practice Association:

Dr. Charles Godfried Otu-nyarko is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Dr. Charles Godfried Otu-nyarko is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
			2530 Bert Kouns Industrial Loop Shreveport, LA - 711183132 Ph: 3182125811	May accept

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Charles Godfried Otu-nyarko are as mentioned. Primary taxonomy code for Dr. Charles Godfried Otu-nyarko, M.D is 2080P0206X (Pediatrics Pediatric Gastroenterology).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	125.052705	IL
2080P0206X	Pediatrics Pediatric Gastroenterology	Yes	MD.203819	LA

Legacy Identifiers:

Other legacy medical identifiers of Dr. Charles Godfried Otu-nyarko such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
2107259	MEDICAID	LA

Other Practice Locations:

Practice Address	City, State	Phone Number
8200 CONSTANTIN BLVD FL 4, BATON ROUGE, LA, 70809-3481 United States	BATON ROUGE, LA	225-765-5500

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	2508 Bert Kouns Loop, Suite 101 Shreveport, LA, 71118-3133 United States
Phone Number :	318-212-5858
Fax Number :	318-212-5877

Business Location:

Patients can refer following map for directions to Dr. Charles Godfried Otu-nyarko practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.