Provider Demographics
NPI:1467890251
Name:MENYAH, MAAME-ESI (PA-C)
Entity Type:Individual
Prefix:MS
First Name:MAAME-ESI
Middle Name:
Last Name:MENYAH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:MAAME-ESI
Other - Middle Name:
Other - Last Name:BUTCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:335 LAMBS GAP RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2784
Mailing Address - Country:US
Mailing Address - Phone:717-591-1425
Mailing Address - Fax:
Practice Address - Street 1:335 LAMBS GAP RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2784
Practice Address - Country:US
Practice Address - Phone:717-591-1425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05054363A00000X
PAMA057313363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant