Provider Demographics
NPI:1497078505
Name:YEBOAH, CHRISTIAN KWABENA (PHARMACIST)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:KWABENA
Last Name:YEBOAH
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8204 CAFFEY DR
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:NC
Mailing Address - Zip Code:27235-9647
Mailing Address - Country:US
Mailing Address - Phone:612-599-5547
Mailing Address - Fax:
Practice Address - Street 1:107 GRAY DRIVE - UNIV OF NORTH CAROLINA
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-1158
Practice Address - Country:US
Practice Address - Phone:336-334-3348
Practice Address - Fax:336-334-3539
Is Sole Proprietor?:No
Enumeration Date:2010-03-03
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist