Provider Demographics
NPI:1750889887
Name:BAIDU-FORSON, AMA KORMA (RDN)
Entity type:Individual
Prefix:MISS
First Name:AMA
Middle Name:KORMA
Last Name:BAIDU-FORSON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE STE 303
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-7036
Mailing Address - Country:US
Mailing Address - Phone:202-889-7900
Mailing Address - Fax:202-610-3095
Practice Address - Street 1:2041 MARTIN LUTHER KING JR AVE SE STE 303
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-7036
Practice Address - Country:US
Practice Address - Phone:202-889-7900
Practice Address - Fax:202-610-3095
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000285133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered