Provider Demographics
NPI:1235877945
Name:BOAMPONG, AMOAFO DWUMFOUR (MD)
Entity Type:Individual
Prefix:MR
First Name:AMOAFO
Middle Name:DWUMFOUR
Last Name:BOAMPONG
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 1:1110 FIDLER LANE
Mailing Address - Street 2:APT # 1505
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:240-936-8424
Mailing Address - Fax:202-865-1773
Practice Address - Street 1:2041 GEORGIA AVENUE, NW HOWARD UNIVERSITY HOSPITAL,
Practice Address - Street 2:SUITE 2039
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060
Practice Address - Country:US
Practice Address - Phone:202-689-5399
Practice Address - Fax:202-865-1773
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2023-03-07
Deactivation Date:2023-02-20
Deactivation Code:
Reactivation Date:2023-03-01
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMTL600001600390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program