Provider Demographics
NPI:1457002735
Name:BAIDOO, KWASI ARTHUR
Entity Type:Individual
Prefix:
First Name:KWASI
Middle Name:ARTHUR
Last Name:BAIDOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 HARVEST WALK
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5514
Mailing Address - Country:US
Mailing Address - Phone:478-508-1333
Mailing Address - Fax:
Practice Address - Street 1:326 HARVEST WALK
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-5514
Practice Address - Country:US
Practice Address - Phone:478-508-1333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-18
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty