Provider Demographics
NPI:1447440151
Name:FIAKYE-AGYEMAN, KWADWO BIOH (LPN)
Entity type:Individual
Prefix:MR
First Name:KWADWO
Middle Name:BIOH
Last Name:FIAKYE-AGYEMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:MR
Other - First Name:KWADWO
Other - Middle Name:BIOH
Other - Last Name:FIAKYE-AGYEMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:3050 VISTA VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6921
Mailing Address - Country:US
Mailing Address - Phone:614-823-8755
Mailing Address - Fax:
Practice Address - Street 1:3050 VISTA VIEW BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6921
Practice Address - Country:US
Practice Address - Phone:614-823-8755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2007-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN118274164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse