| Doctor Name: | ERMIAS MEKONNEN AYTENFISU |
| NPI Number: | 1346436276 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 149291 |
| Business Practice Address: | 1380 E Medical Center Dr St George, UT - 847902123 |
| Business Phone Number: | 4352511000 |
| Business Fax Number: | |
| Mailing Address: | Po Box 30180, SALT LAKE CITY |
| State: | UT |
| Postal Code: | 841300180 |
| Phone Number: | 8048938656 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2007 |
| NPI Last Update Date: | 11/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 149291 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |