Healthcare Provider Details

I. General information

NPI: 1548919087
Provider Name (Legal Business Name): KELVIN KWEKU AMPEM-DARKO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2022
Last Update Date: 05/02/2026
Certification Date: 05/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 REHILL AVE
SOMERVILLE NJ
08876-2519
US

IV. Provider business mailing address

110 REHILL AVE
SOMERVILLE NJ
08876-2519
US

V. Phone/Fax

Practice location:
  • Phone: 908-685-2200
  • Fax:
Mailing address:
  • Phone: 908-685-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number25MA12993100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: