Provider Demographics
NPI:1952984775
Name:ACHEAMPONG, DORCAS (NP)
Entity type:Individual
Prefix:
First Name:DORCAS
Middle Name:
Last Name:ACHEAMPONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 THOMAS JOHNSON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4432
Mailing Address - Country:US
Mailing Address - Phone:301-447-0710
Mailing Address - Fax:301-447-0771
Practice Address - Street 1:198 THOMAS JOHNSON DR STE 103
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4432
Practice Address - Country:US
Practice Address - Phone:301-447-0710
Practice Address - Fax:301-447-0771
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-29
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR214555363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty