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General NPI Number Information
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NPI Number | 1881668937
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Entity Type | Individual
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Provider Name | YAW OTCHERE-BOATENG MD
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Gender | Male
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 1627 QUARRIER ST
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City | CHARLESTON
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State | WV
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Zip | 25311-2124
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Country | US
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Telephone | 757-536-2246
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Fax |
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Provider Business Mailing Address
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Address Line | 1005 CARRINGTON CT
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City | KINGSPORT
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State | TN
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Zip | 37660-5694
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Country | US
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Telephone | 236-777-0404
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 40708
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101242839
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 40708
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License Number State | TN
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Taxonomy #5
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number | FO3926663
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 40708
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 43217
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License Number State | KY
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Taxonomy #8
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 29872
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License Number State | WV
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