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NPI Code Detail

MEDICARE: MRS. AKUORKOR A ADDY M.D.

MEDICARE: MRS. AKUORKOR A ADDY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician4301059998MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356330864
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AKUORKOR A ADDY M.D.
Provider Business Mailing Address
First Line : 733 ALGER ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3530
Country : US
Telephone Number : 616-243-9515
Fax Number : 616-243-1815
Provider Business Practice Location Address
First Line : 733 ALGER ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49507-3530
Country : US
Telephone Number : 616-243-9515
Fax Number : 616-243-1815
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 07/08/2007

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