Provider Demographics
NPI:1821005539
Name:FRIMPONG-BADU, YAW B (MD)
Entity Type:Individual
Prefix:
First Name:YAW
Middle Name:B
Last Name:FRIMPONG-BADU
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 1:17201 I H 45 S
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3311
Mailing Address - Country:US
Mailing Address - Phone:936-270-2099
Mailing Address - Fax:
Practice Address - Street 1:17201 I H 45 S
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:936-270-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232973207R00000X
TXM9289207RG0300X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2580615OtherUNITED HEALTHCARE
NYTINOtherHORIZON HEALTHCARE
NY0587997OtherCIGNA
NY1078431OtherAETNA - HMO
NY4C8141OtherHEALTH NET
NYP3631301OtherOXFORD HEALTH PLANS
NYTINOtherMULTIPLAN
TX199657104Medicaid
NY326AP2OtherEMPIRE BC/BS
NY7192773OtherAETNA - PPO
NY326AP2OtherEMPIRE BC/BS
NY326AP1Medicare PIN