Provider Demographics
NPI:1679778765
Name:ASOMBANG, AKWI WASI (MD)
Entity Type:Individual
Prefix:DR
First Name:AKWI
Middle Name:WASI
Last Name:ASOMBANG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4513
Mailing Address - Country:US
Mailing Address - Phone:401-444-6779
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:119 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2903
Practice Address - Country:US
Practice Address - Phone:508-334-8515
Practice Address - Fax:508-334-6490
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2021-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA265422207RG0100X
RIMD16117207RG0100X
MO2008011777207RG0100X
MI4301113276207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology