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General NPI Number Information
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NPI Number | 1689630691
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Entity Type | Individual
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Provider Name | HANS MAWULI KWAKU M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 5815 BLAKENEY PARK DR STE 200B
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City | CHARLOTTE
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State | NC
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Zip | 28277-5734
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Country | US
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Telephone | 704-316-5080
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Fax | 704-316-5085
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 200300167
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207QA0000X
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Taxonomy Name | Adolescent Medicine (Family Medicine) Physician
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License Number | 200300167
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 200300167
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | 200300167
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License Number State | NC
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 200300167
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License Number State | NC
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