Healthcare Provider Details

I. General information

NPI: 1619296878
Provider Name (Legal Business Name): DADRIE FREDA BAPTISTE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2010
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 HIGHWAY 54 W STE 305
FAYETTEVILLE GA
30214-4537
US

IV. Provider business mailing address

908 NIAGARA FALLS BLVD STE 208
NORTH TONAWANDA NY
14120-2019
US

V. Phone/Fax

Practice location:
  • Phone: 770-719-5660
  • Fax:
Mailing address:
  • Phone: 716-692-3302
  • Fax: 833-953-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number307424
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number307424
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number111217
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD466760
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD466760
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: