Provider Demographics
NPI:1508002015
Name:ADZOKPA, SELORM AMAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SELORM
Middle Name:AMAH
Last Name:ADZOKPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 ALBION ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-2918
Mailing Address - Country:US
Mailing Address - Phone:615-341-4397
Mailing Address - Fax:
Practice Address - Street 1:1818 ALBION ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208-2918
Practice Address - Country:US
Practice Address - Phone:615-341-4397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3920200000X207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine