Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 2011001620 | MO |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 266455 | NY |
NPI | 1154468833 |
---|---|
Provider Name | Dr. Addisu Mesfin |
First Address | Rochester, NY 14642 |
Second Address | Rochester, NY 14642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 04/10/2012 |