Provider Demographics
NPI:1215538368
Name:OUKA, DAWIT W
Entity type:Individual
Prefix:
First Name:DAWIT
Middle Name:W
Last Name:OUKA
Suffix:
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 1:1560 WASHINGTON ST E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2518
Mailing Address - Country:US
Mailing Address - Phone:443-473-8323
Mailing Address - Fax:
Practice Address - Street 1:1 DUNBAR PLZ STE 200
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-3038
Practice Address - Country:US
Practice Address - Phone:304-342-5839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-05
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant