Provider Demographics
NPI:1992425631
Name:OWUSU, EVELYN (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:OWUSU
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 ENGLISH OAK RD APT I
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6779
Mailing Address - Country:US
Mailing Address - Phone:443-635-8944
Mailing Address - Fax:
Practice Address - Street 1:9300 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-4953
Practice Address - Country:US
Practice Address - Phone:410-363-8066
Practice Address - Fax:410-363-2647
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28771183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist