Healthcare Provider Details

I. General information

NPI: 1003937509
Provider Name (Legal Business Name): NANA KWAKU OPARE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVEN GLENN STEPTO MD

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 RESEARCH CENTER ATLANTA DR SW SUITE A
ATLANTA GA
30331-2034
US

IV. Provider business mailing address

1045 RESEARCH CENTER ATLANTA DR SW SUITE A
ATLANTA GA
30331-2034
US

V. Phone/Fax

Practice location:
  • Phone: 404-696-1773
  • Fax: 404-696-1775
Mailing address:
  • Phone: 404-696-1773
  • Fax: 404-696-1775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number058113
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number058113
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: