Organization
HAVASU NEUROLOGICAL CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAAME A DANKWAH-QUANSAH M.D. (OWNER/MEMBER)
(928) 680-4040
Entity
Organization
Contact information
Practice address
297 LAKE HAVASU AVE S, SUITE 106, LAKE HAVASU CITY, AZ 86403-6526
(928) 680-4040
(928) 680-4484
Mailing address
297 LAKE HAVASU AVE S, SUITE 106, LAKE HAVASU CITY, AZ 86403-6526
(928) 680-4040
(928) 680-4484
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
872509
—
AZ
01
—
P-1875159-0
CORPORATION NUMBER
AZ
Enumeration date
10/01/2013
Last updated
03/13/2014
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