Provider Demographics
NPI:1497251474
Name:OPPONG-TWENE, PHILIP (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:OPPONG-TWENE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 BILL CARRUTH PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-3756
Mailing Address - Country:US
Mailing Address - Phone:943-202-7120
Mailing Address - Fax:470-986-7087
Practice Address - Street 1:148 BILL CARRUTH PKWY STE 120
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-3756
Practice Address - Country:US
Practice Address - Phone:943-202-7120
Practice Address - Fax:470-986-7087
Is Sole Proprietor?:No
Enumeration Date:2018-03-30
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA100315207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology