Provider Demographics
NPI:1033573803
Name:AGYEM, KWESI FREMPONG (BSC, MD)
Entity Type:Individual
Prefix:DR
First Name:KWESI
Middle Name:FREMPONG
Last Name:AGYEM
Suffix:
Gender:M
Credentials:BSC, MD
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Mailing Address - Street 1:135 ONTARIO ST
Mailing Address - Street 2:APT 1308
Mailing Address - City:KINGSTON
Mailing Address - State:ON
Mailing Address - Zip Code:K7L0A5
Mailing Address - Country:CA
Mailing Address - Phone:613-483-0222
Mailing Address - Fax:
Practice Address - Street 1:76 STUART ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:ONTARIO
Practice Address - Zip Code:K7L2V7
Practice Address - Country:CA
Practice Address - Phone:613-549-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ZZ3902000002085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology