Healthcare Provider Details

I. General information

NPI: 1881071223
Provider Name (Legal Business Name): MILLICENT AMANKWAH M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 PLEASANT ST STE 250
DES MOINES IA
50309-1423
US

IV. Provider business mailing address

1221 PLEASANT ST STE 250
DES MOINES IA
50309-1423
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-4674
  • Fax:
Mailing address:
  • Phone: 515-241-4674
  • Fax: 515-241-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number12881256
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number54516
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: