Provider Demographics
NPI:1295294064
Name:OBENG, GEORGE BOAKYE
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:BOAKYE
Last Name:OBENG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 STADIUM DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-7911
Mailing Address - Country:US
Mailing Address - Phone:304-598-4871
Mailing Address - Fax:304-598-4871
Practice Address - Street 1:1930 ALCOA HWY STE 145
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1546
Practice Address - Country:US
Practice Address - Phone:865-305-6570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN73395207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program