Provider Demographics
NPI:1073740726
Name:ACHAMPONG, HENRY ADJEI (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:ADJEI
Last Name:ACHAMPONG
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 1:5901 MONTROSE RD APT S1006
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4736
Mailing Address - Country:US
Mailing Address - Phone:973-392-7703
Mailing Address - Fax:
Practice Address - Street 1:2200 DEFENSE HWY STE 203
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2927
Practice Address - Country:US
Practice Address - Phone:301-926-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0009513207L00000X, 207LP2900X, 208VP0014X
MDD0072898208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1073740726Medicaid