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General NPI Number Information
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NPI Number | 1487880761
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Entity Type | Individual
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Provider Name | WILLIAM OPOKU BADU AGYEMANG ANP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 05/22/2015
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Provider Practice Location Address
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Address Line | 851 SOUTHBRIDGE BLVD
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City | SAVANNAH
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State | GA
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Zip | 31405-1096
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Country | US
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Telephone | 912-663-6502
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Fax |
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Provider Business Mailing Address
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Address Line | 200 GULF STREAM ROAD
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City | GARDEN CITY
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State | GA
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Zip | 31408
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Country | US
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Telephone | 912-965-6329
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN154407 NP
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License Number State | GA
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