Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 0101248909 | VA |
N | 207L00000X | Anesthesiologist | A76514 | CA |
NPI | 1003092032 |
---|---|
Provider Name | Dr. Major K Boateng |
First Address | Fairfax, VA 22033-2907 |
Second Address | Hampton, VA 23666-6080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2008 |
Last Update Date | 14/01/2015 |