Provider Demographics
NPI:1811458714
Name:ASAMOAH, EUCABETH MOSE (MD)
Entity type:Individual
Prefix:
First Name:EUCABETH
Middle Name:MOSE
Last Name:ASAMOAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EUCABETH
Other - Middle Name:AKINYI
Other - Last Name:MOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:210 9TH ST SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-6756
Mailing Address - Country:US
Mailing Address - Phone:507-288-3443
Mailing Address - Fax:
Practice Address - Street 1:210 9TH ST SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-6756
Practice Address - Country:US
Practice Address - Phone:507-288-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-25
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN30271207R00000X
MN67779207ND0101X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine