Individual
KWAKU AMEXO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 WASHINGTON AVE, UNIT 710, PHILADELPHIA, PA 19147-3839
(609) 506-5543
Mailing address
1101 WASHINGTON AVE, UNIT 710, PHILADELPHIA, PA 19147-3839
(609) 506-5543
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD056047
PA
207R00000X
Internal Medicine Physician
Primary
MD056047L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001584998
—
PA
05
—
001584998 0008
—
PA
01
—
0198383000
KEYSTONE HEALTH PLAN EAST
PA
01
—
P00766575
RR MEDICARE
PA
Enumeration date
05/24/2006
Last updated
03/11/2013
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