Provider Demographics
NPI:1922648609
Name:ABOAGYE, NANA BOAFO III
Entity Type:Individual
Prefix:
First Name:NANA
Middle Name:BOAFO
Last Name:ABOAGYE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7831 LEWIS CHAPEL CIR APT 402
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1952
Mailing Address - Country:US
Mailing Address - Phone:703-343-3461
Mailing Address - Fax:
Practice Address - Street 1:7831 LEWIS CHAPEL CIR APT 402
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1952
Practice Address - Country:US
Practice Address - Phone:703-343-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)