Provider Demographics
NPI:1548091317
Name:DORMAH BOADU, DOREEN ADWOBI (PHARMD)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:ADWOBI
Last Name:DORMAH BOADU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WILLIAMSBERG DR APT B
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01602-3041
Mailing Address - Country:US
Mailing Address - Phone:508-762-7277
Mailing Address - Fax:
Practice Address - Street 1:227 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-4838
Practice Address - Country:US
Practice Address - Phone:603-666-8538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH1000693183500000X
NHPHCY-05074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist