Individual
DAVID KWAME TAWIAH GBOLOO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2524 SOUTH PHILIPPE AVE, GONZALES, LA 70737
(225) 644-1990
(225) 644-3264
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13365R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1562262
—
LA
Enumeration date
09/14/2006
Last updated
05/26/2022
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