Basic Information
Provider Information
NPI: 1275970048
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ACHEAMPONG
FirstName: BENJAMIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MBCHB
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 719 THOMPSON LN STE 30330
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372044701
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Practice Location
Address1: 3601
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372320001
CountryCode: US
TelephoneNumber: 6153223000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/03/2013
LastUpdateDate: 12/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/11/2019

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202XMD55026TNY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


Home