Provider Demographics
NPI:1891084802
Name:KUMI, KOFI AMOA (PHD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KOFI
Middle Name:AMOA
Last Name:KUMI
Suffix:
Gender:M
Credentials:PHD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 GRAVENHURST CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3446
Mailing Address - Country:US
Mailing Address - Phone:301-792-4737
Mailing Address - Fax:
Practice Address - Street 1:250 W CHASE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4815
Practice Address - Country:US
Practice Address - Phone:410-752-4473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13743183500000X
TX27410183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist