Healthcare Provider Details

I. General information

NPI: 1952212193
Provider Name (Legal Business Name): TRICIA BEMAH ADOMAKO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E BROADWAY AVE
BISMARCK ND
58501-4407
US

IV. Provider business mailing address

1611 31ST ST NW APT 210
MANDAN ND
58554-1412
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-6717
  • Fax:
Mailing address:
  • Phone: 914-531-5934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberRL24493
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: