Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 064884 | GA |
N | 207RI0200X | Infectious Disease | 259542 | NY |
NPI | 1013236165 |
---|---|
Provider Name | Christian Aidoo |
First Address | Mcdonough, GA 30253-4900 |
Second Address | Mcdonough, GA 30253-4900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2010 |
Last Update Date | 22/02/2013 |