Provider Demographics
NPI:1104106152
Name:YAMOAH, KOSJ (MD PHD)
Entity type:Individual
Prefix:DR
First Name:KOSJ
Middle Name:
Last Name:YAMOAH
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:DR
Other - First Name:SIMEON JAMES KOSJ
Other - Middle Name:
Other - Last Name:YAMOAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD PHD
Mailing Address - Street 1:12902 USF MAGNOLIA DR
Mailing Address - Street 2:MCC-RAD ONC
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-9416
Mailing Address - Country:US
Mailing Address - Phone:888-663-3488
Mailing Address - Fax:
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:MCC-RAD ONC
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:888-663-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT198690207R00000X, 2085R0001X
FLME1246462085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine