Provider Demographics
NPI:1013915065
Name:AFRIYIE-GRAY, AKUA TIWAA (MD)
Entity Type:Individual
Prefix:
First Name:AKUA
Middle Name:TIWAA
Last Name:AFRIYIE-GRAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AKUA
Other - Middle Name:TIWAA
Other - Last Name:AFRIYIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD STE 303
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3080
Mailing Address - Country:US
Mailing Address - Phone:512-324-0970
Mailing Address - Fax:
Practice Address - Street 1:1301 BARBARA JORDAN BLVD STE 303
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3080
Practice Address - Country:US
Practice Address - Phone:512-324-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-01-26
Deactivation Date:2006-03-31
Deactivation Code:
Reactivation Date:2006-05-01
Provider Licenses
StateLicense IDTaxonomies
IL036-111444207V00000X
TXT1626207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI17140OtherBLUE CROSS BLUE SHIELD
IL689990OtherHEALTHLINK
IL036111444Medicaid
IL098801OtherHEALTH ALLIANCE
ILCF3444OtherMEDICARE RAILROAD
IL689990OtherHEALTHLINK
ILI17140OtherBLUE CROSS BLUE SHIELD
ILCF3444OtherMEDICARE RAILROAD