Provider Demographics
NPI:1437143757
Name:SEFA, AKWASI A (MD)
Entity Type:Individual
Prefix:DR
First Name:AKWASI
Middle Name:A
Last Name:SEFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AKWASI
Other - Middle Name:
Other - Last Name:ADJARE-SEFA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4570 NORTH BLVD.,
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-925-2331
Mailing Address - Fax:225-923-1886
Practice Address - Street 1:4750 NORTH BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4896
Practice Address - Country:US
Practice Address - Phone:225-925-2331
Practice Address - Fax:225-923-1886
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10886R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1651036Medicaid
LA1651036Medicaid
5U882Medicare PIN