Provider Demographics
NPI:1730381252
Name:OKOH, SAMUEL KOFI OSEI (MD)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:KOFI OSEI
Last Name:OKOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4777
Mailing Address - Country:US
Mailing Address - Phone:843-339-3030
Mailing Address - Fax:843-383-0115
Practice Address - Street 1:701 MEDICAL PARK DR
Practice Address - Street 2:SUITE 208
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4777
Practice Address - Country:US
Practice Address - Phone:843-339-3030
Practice Address - Fax:843-383-0115
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049961207R00000X, 207RN0300X, 207RH0005X
SC35390207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0005XAllopathic & Osteopathic PhysiciansInternal MedicineHypertension Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010049961CT02OtherBCBS
CT008032573Medicaid
CTP01026541OtherRAILROAD
CTP01026541OtherRAILROAD
CTD400063775Medicare PIN