Provider Demographics
NPI:1184884900
Name:BOAH, AKWASI OFORI (MD)
Entity type:Individual
Prefix:DR
First Name:AKWASI
Middle Name:OFORI
Last Name:BOAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KWASI
Other - Middle Name:OFORI
Other - Last Name:BOAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3537 S I 35 E
Mailing Address - Street 2:SUITE 308
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6800
Mailing Address - Country:US
Mailing Address - Phone:940-382-2204
Mailing Address - Fax:940-483-8933
Practice Address - Street 1:3537 S I 35 E
Practice Address - Street 2:SUITE 308
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6800
Practice Address - Country:US
Practice Address - Phone:940-382-2204
Practice Address - Fax:940-483-8933
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD78769207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531131YM9AMedicare UPIN