Provider Demographics
NPI:1770546525
Name:ASANTE, NELSON KWADWO (MD)
Entity type:Individual
Prefix:
First Name:NELSON
Middle Name:KWADWO
Last Name:ASANTE
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:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501
Mailing Address - Country:US
Mailing Address - Phone:570-346-7797
Mailing Address - Fax:570-342-9802
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510
Practice Address - Country:US
Practice Address - Phone:570-346-7797
Practice Address - Fax:570-342-9802
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073017L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00416283OtherRR MEDICARE
PA0018645250004Medicaid
PA050045Medicare ID - Type Unspecified
PA0018645250004Medicaid
PAP00416283OtherRR MEDICARE