Basic Information
Provider Information
NPI: 1780353581
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASAFU-ADJAYE
FirstName: FREMPONG
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2351 E 22ND ST STE 338W
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441153111
CountryCode: US
TelephoneNumber: 2168616200
FaxNumber: 2163637490
Practice Location
Address1: 11100 EUCLID AVE
Address2:  
City: CLEVELAND
State: OH
PostalCode: 441061716
CountryCode: US
TelephoneNumber: 2168443833
FaxNumber: 2168441949
Other Information
ProviderEnumerationDate: 09/07/2021
LastUpdateDate: 10/24/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/24/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X57.251557OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home