Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 4301095841 | MI |
NPI | 1003128810 |
---|---|
Provider Name | Anteneh A Tesfaye |
First Address | Washington, DC 20010-3017 |
Second Address | Washington, DC 20010-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2010 |
Last Update Date | 19/11/2021 |