Provider Demographics
NPI:1407649874
Name:KARGBO, SORIE POREH (MD)
Entity type:Individual
Prefix:DR
First Name:SORIE
Middle Name:POREH
Last Name:KARGBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 CARTER RD
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-1716
Mailing Address - Country:US
Mailing Address - Phone:267-275-9301
Mailing Address - Fax:
Practice Address - Street 1:3031 W GRAND BLVD STE 600
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3014
Practice Address - Country:US
Practice Address - Phone:313-879-6960
Practice Address - Fax:313-879-6960
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program