Basic Information
| Provider Information | |||||||||
| NPI: | 1417215252 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KWAKYE | ||||||||
| FirstName: | KWABENA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 S 7TH AVE | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571050998 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6057828305 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2100 S MARION RD | ||||||||
| Address2: | |||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571063646 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053221010 | ||||||||
| FaxNumber: | 6053221011 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2012 | ||||||||
| LastUpdateDate: | 05/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 43876 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | SD | SD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | 8483 | SD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.