Provider Information for 1508815762
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KWAME S. AMANKWAH MD
Sex: Male
NPI: 1508815762
Last Updated: 2022-09-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508815762 | ||||||||||||||||
| Enumeration Date | 2006-05-08 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-8082 United States Phone: 860-679-8080 | Fax:860-679-1430 | ||||||||||||||||
| Primary Practice Address | 263 FARMINGTON AVE FARMINGTON, CT 06030-0001 United States Phone: 860-679-8080 | Fax:860-679-1430 | ||||||||||||||||
| Secondary Practice Address(es) | 750 E ADAMS ST 750 E ADAMS ST | ||||||||||||||||
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