Individual
KOFI OWUSU-BOAITEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4000
Mailing address
PO BOX 64485, BALTIMORE, MD 21264-4485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0048006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200283
JOHNS HOPKINS HEALTH CARE
MD
01
—
3058457
AETNA HMO
MD
01
—
5227
BRAVO/ELDER HEALTH
MD
01
—
52508
AMERIGROUP
MD
01
—
54236602
CARE FIRST BLUE CROSS
MD
01
—
5617957
CIGNA
MD
01
—
7866416
AETNA PPO
MD
01
—
F551-0003
CARE FIRST BLUE CROSS
DC
Enumeration date
11/21/2005
Last updated
04/16/2008
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