Healthcare Provider Details

I. General information

NPI: 1356397327
Provider Name (Legal Business Name): AFUA BOATEMAA BOIQUAYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S LAKE PARK AVE
HOBART IN
46342-6638
US

IV. Provider business mailing address

1135 STONEBRIDGE DR
SCHERERVILLE IN
46375-1328
US

V. Phone/Fax

Practice location:
  • Phone: 219-942-0551
  • Fax:
Mailing address:
  • Phone: 219-864-2464
  • Fax: 219-864-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number01060535A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01060535A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: