Provider Demographics
NPI:1942501234
Name:OBENG, PAA-KOFI BENIAKO (DO)
Entity Type:Individual
Prefix:DR
First Name:PAA-KOFI
Middle Name:BENIAKO
Last Name:OBENG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 DILIGENCE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4268
Mailing Address - Country:US
Mailing Address - Phone:757-612-4408
Mailing Address - Fax:
Practice Address - Street 1:827 DILIGENCE DR STE 206
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4268
Practice Address - Country:US
Practice Address - Phone:757-612-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102203549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine