Healthcare Provider Details

I. General information

NPI: 1386359891
Provider Name (Legal Business Name): ERIC TWUMASI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4445 CORPORATION LN
VIRGINIA BEACH VA
23462-3262
US

IV. Provider business mailing address

3351 CORRIDOR MARKETPLACE STE 400-21
LAUREL MD
20724-2379
US

V. Phone/Fax

Practice location:
  • Phone: 571-478-3130
  • Fax:
Mailing address:
  • Phone: 240-510-6832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number1382
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: