| Organization Name: | TESFAYE D FANTA MD PLLC |
| NPI Number: | 1033489216 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TESFAYE DEMISSIE FANTA (OWNER) |
| Mailing Address: | 910 W Harrison St Reidsville |
| State: | NC US |
| Postal Code: | 273203324 |
| Phone Number: | 3363429564 |
| Fax Number: | 3363499723 |
| NPI Enumeration Date: | 01/05/2012 |
| NPI Last Update Date: | 01/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RE0101X |
| License Number: | 200900231 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Endocrinology, Diabetes & Metabolism |
| Taxonomy Definition: | An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |