Provider Demographics
NPI:1881695609
Name:SARFO, KOFI E (MD)
Entity type:Individual
Prefix:
First Name:KOFI
Middle Name:E
Last Name:SARFO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 365404
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89036-9404
Mailing Address - Country:US
Mailing Address - Phone:702-798-1233
Mailing Address - Fax:702-531-1233
Practice Address - Street 1:2909 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1925
Practice Address - Country:US
Practice Address - Phone:702-798-1233
Practice Address - Fax:702-531-1233
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2011-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV11205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101185Medicare PIN
H74629Medicare UPIN