Provider Demographics
NPI:1952334112
Name:OFORI-AWUAH, LORRAINE BEATRICE (MD)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:BEATRICE
Last Name:OFORI-AWUAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9305 GLEN VISTA RD
Mailing Address - Street 2:
Mailing Address - City:PERRY HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21128
Mailing Address - Country:US
Mailing Address - Phone:410-933-4970
Mailing Address - Fax:410-933-4971
Practice Address - Street 1:5430 CAMPBELL BLVD.
Practice Address - Street 2:SUITE 214
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:410-933-4970
Practice Address - Fax:410-933-4971
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061789207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD405496200Medicaid
MD405496200Medicaid
MD401P792GMedicare PIN
MD792GMedicare PIN