Provider Demographics
NPI:1942816962
Name:SEFFAH, KOFI DARKWA (MD)
Entity Type:Individual
Prefix:DR
First Name:KOFI
Middle Name:DARKWA
Last Name:SEFFAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 PRINCE AVE #70
Mailing Address - Street 2:1270 PRINCE AVE SUITE 201
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606
Mailing Address - Country:US
Mailing Address - Phone:706-475-7055
Mailing Address - Fax:
Practice Address - Street 1:1199 PRINCE AVE #70
Practice Address - Street 2:1270 PRINCE AVE SUITE 201
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606
Practice Address - Country:US
Practice Address - Phone:706-475-7055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2021-11-09
Deactivation Date:2021-10-20
Deactivation Code:
Reactivation Date:2021-11-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program