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NPI Code Detail

MEDICARE: BONIFACE MENSAH MD, MPH

MEDICARE: BONIFACE MENSAH MD, MPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1124721295
Entity Type Code : Individual
Provider Name (Legal Business Name) : BONIFACE MENSAH MD, MPH
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-1200
Country : US
Telephone Number : 304-598-4000
Fax Number :
Provider Business Practice Location Address
First Line : 1 MEDICAL CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26506-1200
Country : US
Telephone Number : 304-598-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2023
Last Update Date : 06/04/2026

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