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Individual

DR. AFUA SARPON BOATEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1046 RIDGE AVE SW, SOUTHSIDE MEDICAL CENTER, ATLANTA, GA 30315-1640
(404) 688-1350
(404) 801-3959
Mailing address
1046 RIDGE AVE SW, SOUTHSIDE MEDICAL CENTER, ATLANTA, GA 30315-1640
(404) 688-1350
(404) 801-3959

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
47166
TN
207Q00000X
Family Medicine Physician
Primary
54207
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202I080456
MEDICARE PTAN
GA
05
403610618
GA
05
403610618A,B
GA
Enumeration date
09/08/2005
Last updated
02/19/2015
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