Provider Demographics
NPI:1275685166
Name:AMPOMAH, JOHN KWEKU (MD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KWEKU
Last Name:AMPOMAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9176 SHELTON POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-6507
Mailing Address - Country:US
Mailing Address - Phone:804-833-0158
Mailing Address - Fax:
Practice Address - Street 1:7101 JAHNKE RD
Practice Address - Street 2:SUITE 611
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:804-327-4046
Practice Address - Fax:804-323-8180
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN41927207R00000X
VA0101246488207R00000X
NC2007-00216207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4146352OtherBCBS
VA1275685166Medicaid
VAP00811050OtherRAILROAD MEDICARE
TN3834086Medicaid
VA1275685166Medicaid
TN3834086Medicaid