Provider Demographics
NPI:1457963951
Name:NKRUMAH, MICHAEL ASAMOAH (PHARM D, PA-C)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ASAMOAH
Last Name:NKRUMAH
Suffix:
Gender:M
Credentials:PHARM D, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55807-2754
Mailing Address - Country:US
Mailing Address - Phone:218-628-2897
Mailing Address - Fax:
Practice Address - Street 1:1101 9TH ST N
Practice Address - Street 2:
Practice Address - City:VIRGINIA
Practice Address - State:MN
Practice Address - Zip Code:55792-2329
Practice Address - Country:US
Practice Address - Phone:218-305-0000
Practice Address - Fax:218-749-7844
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN14887363A00000X
MN124419183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No183500000XPharmacy Service ProvidersPharmacist