| Doctor Name: | DR. CLETUS KOBIAH OPPONG |
| NPI Number: | 1912264284 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | 73916 |
| Business Practice Address: | 47 New Scotland Ave Department Of Anesthesiology Albany, NY - 122083412 |
| Business Phone Number: | 5182623095 |
| Business Fax Number: | |
| Mailing Address: | 47 New Scotland Ave, Department Of Anesthesiology ALBANY |
| State: | NY |
| Postal Code: | 122083412 |
| Phone Number: | 5182623095 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2012 |
| NPI Last Update Date: | 05/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 73916 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |