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NPI Code Detail

MEDICARE: DR. SAMUEL ASANTE-BUABENG M.D.

MEDICARE: DR. SAMUEL ASANTE-BUABENG 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
1207Q00000XFamily Medicine Physician50756MN

General Provider Information

NPI Number : 1558520361
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SAMUEL ASANTE-BUABENG M.D.
Provider Business Mailing Address
First Line : 8170 33RD AVE S # MS 21110Q
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4670 PARK NICOLLET AVE SE
Second Line :
City : PRIOR LAKE
State : MN
Zip : 55372-4119
Country : US
Telephone Number : 952-993-7750
Fax Number : 952-993-8820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2008
Last Update Date : 03/12/2021

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