Healthcare Provider Details

I. General information

NPI: 1376465245
Provider Name (Legal Business Name): KWEISI SETH AMPARBENG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 CARIBOU RUN
DELAWARE OH
43015-7230
US

IV. Provider business mailing address

1226 CARIBOU RUN
DELAWARE OH
43015-7230
US

V. Phone/Fax

Practice location:
  • Phone: 614-779-4374
  • Fax:
Mailing address:
  • Phone: 614-779-4374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number202616205490
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: