Provider Demographics
NPI:1578855706
Name:OBENG-GYIMAH, EDMOND K (MD)
Entity Type:Individual
Prefix:
First Name:EDMOND
Middle Name:K
Last Name:OBENG-GYIMAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2441
Mailing Address - Fax:
Practice Address - Street 1:30 MONUMENT RD
Practice Address - Street 2:SUITE 1100
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-5024
Practice Address - Country:US
Practice Address - Phone:717-851-2441
Practice Address - Fax:717-851-3521
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD452963207RC0000X, 207RC0001X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease