MEDICARE: MR. ALFRED NKRUMAH ASAMOAH MSW

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
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1992081541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALFRED NKRUMAH ASAMOAH MSW

Provider Business Mailing Address
First Line	:	2501 SOUTH BIG BEND
Second Line	:
City	:	ST LOUIS
State	:	MO
Zip	:	63143
Country	:	US
Telephone Number	:	314-520-9759
Fax Number	:

Provider Business Practice Location Address
First Line	:	2501 S BIG BEND BLVD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63143-2122
Country	:	US
Telephone Number	:	314-520-9759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2011
Last Update Date	:	10/27/2011

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