Provider Demographics
NPI:1407351257
Name:KWAMI, DAVID SELASI
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SELASI
Last Name:KWAMI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-5235
Mailing Address - Country:US
Mailing Address - Phone:401-999-2323
Mailing Address - Fax:401-382-3802
Practice Address - Street 1:2 YALE AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908-5235
Practice Address - Country:US
Practice Address - Phone:401-999-2323
Practice Address - Fax:401-382-3802
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN01797363L00000X, 363LF0000X
MARN2291423363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner