Provider Demographics
NPI:1336464478
Name:ASAMOAH-CLARK, NIKIYA O (MD)
Entity Type:Individual
Prefix:
First Name:NIKIYA
Middle Name:O
Last Name:ASAMOAH-CLARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIKIYA
Other - Middle Name:O
Other - Last Name:ASAMOAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-3017
Mailing Address - Country:US
Mailing Address - Phone:202-877-7108
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-3017
Practice Address - Country:US
Practice Address - Phone:202-877-7108
Practice Address - Fax:202-877-3062
Is Sole Proprietor?:No
Enumeration Date:2010-04-01
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135318207RG0100X
DCMD210001577207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology