Provider Demographics
NPI:1073800041
Name:SAM, ABIGAIL AKOMAH-GYAMFI (MD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:AKOMAH-GYAMFI
Last Name:SAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:AKOMAH-GYAMFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:405 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3222
Mailing Address - Country:US
Mailing Address - Phone:910-615-5800
Mailing Address - Fax:910-875-0309
Practice Address - Street 1:405 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3222
Practice Address - Country:US
Practice Address - Phone:910-615-5800
Practice Address - Fax:910-875-0309
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01897207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine