Individual
EDWIN ETSE KWAKUGAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201-4036
(701) 780-5000
(701) 780-1892
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201-4183
(701) 780-4085
(701) 780-4477
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14567
ND
390200000X
Student in an Organized Health Care Education/Training Program
14567
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Enumeration date
08/04/2014
Last updated
06/08/2020
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