Provider Demographics
NPI:1427221621
Name:ASIAMAH, KOFI AWUAH (MD)
Entity Type:Individual
Prefix:DR
First Name:KOFI
Middle Name:AWUAH
Last Name:ASIAMAH
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 1:26151 LAKE SHORE BLVD
Mailing Address - Street 2:1207
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-1176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13951 TERRACE RD
Practice Address - Street 2:GME OFFICE
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-4308
Practice Address - Country:US
Practice Address - Phone:216-761-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090747207R00000X
WI51408-20207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI35104600Medicaid