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Individual

AKUA AMPONSAH SAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
80 PHOENIX AVE, WATERBURY, CT 06702-1418
(203) 756-8021
Mailing address
173 POND VIEW DR, WATERTOWN, CT 06795-3152

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036450
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001364504
CT
Enumeration date
08/16/2005
Last updated
05/03/2011
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