Individual
DR. KENNETH NANA AFFOH OFORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 491-6000
(317) 491-6534
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
01088669A
IN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
01088669A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068010895
MEDICARE PTAN
IN
05
—
300077763
—
IN
Enumeration date
05/10/2017
Last updated
08/16/2023
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