Provider Demographics
NPI:1659359487
Name:BADOE, PAPA KAKU (MD)
Entity type:Individual
Prefix:
First Name:PAPA
Middle Name:KAKU
Last Name:BADOE
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 1:60 MESSENGER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2258
Mailing Address - Country:US
Mailing Address - Phone:508-809-6378
Mailing Address - Fax:508-342-1912
Practice Address - Street 1:60 MESSENGER ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762-2258
Practice Address - Country:US
Practice Address - Phone:508-809-6378
Practice Address - Fax:508-342-1912
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ44750OtherBLUE CROSS
MA110060928AMedicaid
MAAA152319OtherHARVARD PILGRIM
MAAA152319OtherHARVARD PILGRIM
MA110060928AMedicaid