Healthcare Provider Details

I. General information

NPI: 1184887218
Provider Name (Legal Business Name): ISAAC OPOKU-ASARE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

15252 BRIARCLIFF MANOR WAY
BURTONSVILLE MD
20866-1658
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-6792
  • Fax:
Mailing address:
  • Phone: 862-222-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD038165
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD446798
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: