Healthcare Provider Details

I. General information

NPI: 1598827172
Provider Name (Legal Business Name): AKOSUA FLORA AMANKWAH WRIGHT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 SURRATTS RD STE 303
CLINTON MD
20735-3377
US

IV. Provider business mailing address

7501 SURRATTS RD STE 303
CLINTON MD
20735-3377
US

V. Phone/Fax

Practice location:
  • Phone: 301-877-5607
  • Fax:
Mailing address:
  • Phone: 301-877-5607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA030446
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: