Provider Demographics
NPI:1043604283
Name:AGYEMANG, AMMA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:AMMA
Middle Name:
Last Name:AGYEMANG
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 TIVOLI LAKE CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-5905
Mailing Address - Country:US
Mailing Address - Phone:617-869-6274
Mailing Address - Fax:
Practice Address - Street 1:3601 HOUMA BLVD STE 203
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-4301
Practice Address - Country:US
Practice Address - Phone:504-412-1650
Practice Address - Fax:504-412-1660
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA341123207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program