Individual
MAXWELL PROSPER KWAKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 5TH STREET, TYLER, TX 75701
(903) 590-5190
(903) 590-5199
Mailing address
PO BOX 9477, TYLER, TX 75711-9477
(903) 594-2450
(903) 509-0943
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
M1861
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00229235
MEDICARE RR
—
Enumeration date
06/27/2006
Last updated
03/08/2018
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