| Kwabena Adubofour, Md Inc | |
|
2524 E Main St Stockton CA 95205-6523 | |
| (800) 249-9497 | |
| (209) 845-1364 |
| Full Name | Kwabena Adubofour, Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2524 E Main St, Stockton, California |
| Authorized Official Name and Position | Kwabena Adubofour (OWNER) |
| Authorized Official Contact | 8002499497 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kwabena Adubofour, Md Inc Po Box 188 Oakdale CA 95361-0188 Ph: (800) 249-9497 | Kwabena Adubofour, Md Inc 2524 E Main St Stockton CA 95205-6523 Ph: (800) 249-9497 |
| NPI Number | 1386860765 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8325173040 |
|---|---|
| Medicare Enrollment ID | O20100319000825 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386860765 | NPI | - | NPPES |
| 00A523940 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A52394 (Arkansas) | Primary |
| Provider Name | Kwabena O Adubofour |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033142088 PECOS PAC ID: 0244278851 Enrollment ID: I20050422000597 |
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