Provider Demographics
NPI:1366070187
Name:ACQUAH, FREDERICK (MD/MBA)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:
Last Name:ACQUAH
Suffix:
Gender:M
Credentials:MD/MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 HOOPER AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8175
Mailing Address - Country:US
Mailing Address - Phone:848-223-7120
Mailing Address - Fax:732-349-6919
Practice Address - Street 1:1868 HOOPER AVE STE 6
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-8175
Practice Address - Country:US
Practice Address - Phone:848-223-7120
Practice Address - Fax:732-349-6919
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA11736200207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program