Provider Demographics
NPI:1861651846
Name:KWEKU, JOSEPHINE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:KWEKU
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 1:5007 GREENHILL AVE.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206
Mailing Address - Country:US
Mailing Address - Phone:410-949-6610
Mailing Address - Fax:
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:GENERAL SURGERY, N4E29
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-4089
Practice Address - Fax:410-328-1012
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8265207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology