Doctor Name: | BEELETSEGA T YENENEH |
NPI Number: | 1528367166 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | 6644 E Baywood Ave C/o Theresa Evans, Hospitalist Team Manager Mesa, AZ - 852061747 |
Business Phone Number: | 4803213844 |
Business Fax Number: | 4803213840 |
Mailing Address: | 6644 E Baywood Ave, C/o Theresa Evans, Hospitalist Team Manager MESA |
State: | AZ |
Postal Code: | 852061747 |
Phone Number: | 4803213844 |
Fax Number: | 4803213840 |
NPI Enumeration Date: | 03/22/2011 |
NPI Last Update Date: | 11/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
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. |