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General NPI Number Information
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NPI Number | 1437470085
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Entity Type | Individual
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Provider Name | KWAME GYASI M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2010
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 6201 ANNAPOLIS RD
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City | LANDOVER HILLS
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State | MD
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Zip | 20784-1307
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Country | US
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Telephone | 301-276-3377
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Fax |
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Provider Business Mailing Address
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Address Line | 506 LENOX AVE
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City | NEW YORK
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State | NY
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Zip | 10037-1802
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Country | US
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Telephone | 917-969-9287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D0099979
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License Number State | MD
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