Healthcare Provider Details

I. General information

NPI: 1407025067
Provider Name (Legal Business Name): KWASI OPUNI BOAKYE, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 S HOWELL ST
HILLSDALE MI
49242-1820
US

IV. Provider business mailing address

30 S HOWELL ST
HILLSDALE MI
49242-1820
US

V. Phone/Fax

Practice location:
  • Phone: 517-437-7800
  • Fax: 517-437-7825
Mailing address:
  • Phone: 517-437-7800
  • Fax: 517-437-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number4301071567
License Number StateMI

VIII. Authorized Official

Name: DR. KWASI OPUNI BOAKYE
Title or Position: OWNER
Credential: M.D.
Phone: 517-437-7800