Provider Demographics
NPI:1730751058
Name:A. AGYEMAN, MD MEDICAL CORP.
Entity type:Organization
Organization Name:A. AGYEMAN, MD MEDICAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKUA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGYEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:305-924-3345
Mailing Address - Street 1:1560 HUMBOLDT RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9101
Mailing Address - Country:US
Mailing Address - Phone:530-592-4334
Mailing Address - Fax:530-592-4335
Practice Address - Street 1:1560 HUMBOLDT RD STE 2
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9101
Practice Address - Country:US
Practice Address - Phone:530-592-4334
Practice Address - Fax:530-592-4335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care