Provider Demographics
NPI:1033850219
Name:OWUSUWAAH, DANIELLA NANA (DO)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:NANA
Last Name:OWUSUWAAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9908 COULOAK DR STE 103
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28216-8678
Mailing Address - Country:US
Mailing Address - Phone:704-801-2025
Mailing Address - Fax:
Practice Address - Street 1:9908 COULOAK DR STE 103
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-8678
Practice Address - Country:US
Practice Address - Phone:704-801-2025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2025-01600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics