Healthcare Provider Details

I. General information

NPI: 1285679845
Provider Name (Legal Business Name): KWADWO GYARTENG-DAKWA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 N DUKE ST SUITE 303B
DURHAM NC
27704
US

IV. Provider business mailing address

2609 N DUKE ST SUITE 303B
DURHAM NC
27704-3048
US

V. Phone/Fax

Practice location:
  • Phone: 919-220-0107
  • Fax: 919-220-7623
Mailing address:
  • Phone: 919-220-0107
  • Fax: 919-220-7623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number200500050
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: