Healthcare Provider Details

I. General information

NPI: 1457963951
Provider Name (Legal Business Name): MICHAEL ASAMOAH NKRUMAH PHARM D, PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2020
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 9TH ST N
VIRGINIA MN
55792-2329
US

IV. Provider business mailing address

4501 GRAND AVE
DULUTH MN
55807-2754
US

V. Phone/Fax

Practice location:
  • Phone: 218-305-0000
  • Fax: 218-749-7844
Mailing address:
  • Phone: 218-628-2897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number14887
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number124419
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: