MEDICARE: KWADWO AGYEI-GYAMFI M.D.

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
1	207RG0100X	Gastroenterology Physician	2011-00720	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00158641	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568414720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWADWO AGYEI-GYAMFI M.D.

Provider Business Mailing Address
First Line	:	2914 N ELM ST
Second Line	:	PMB 130
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2981
Country	:	US
Telephone Number	:	910-739-5197
Fax Number	:	910-739-5294

Provider Business Practice Location Address
First Line	:	4348 FAYETTEVILLE RD
Second Line	:
City	:	LUMBERTON
State	:	NC
Zip	:	28358-2677
Country	:	US
Telephone Number	:	910-739-2519
Fax Number	:	910-739-5294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	01/28/2026

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