Provider Demographics
NPI:1023751765
Name:BAIDOO, PATRICIA KWARTENGMAA (PHARMD)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KWARTENGMAA
Last Name:BAIDOO
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 1:1515 SEVEN PINES RD APT A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-7108
Mailing Address - Country:US
Mailing Address - Phone:217-210-1805
Mailing Address - Fax:
Practice Address - Street 1:2300 GRAND CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:WV
Practice Address - Zip Code:26105-1347
Practice Address - Country:US
Practice Address - Phone:304-295-4573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0007708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist