Healthcare Provider Details
I. General information
NPI: 1730383019
Provider Name (Legal Business Name): SOLOMON SAMUEL KUAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2220 CANTERBURY DR
HAYS KS
67601-2370
US
IV. Provider business mailing address
220 RENNIE AVE
VENICE CA
90291-2646
US
V. Phone/Fax
- Phone: 785-623-5000
- Fax:
- Phone: 504-202-8057
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 245261 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | A115819 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 04-35559 |
| License Number State | KS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: