Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125057373 | IL |
N | 111NI0900X | Internist | 125057373 | IL |
N | 207R00000X | Internist | 41573 | IA |
N | 111NI0900X | Internist | 41573 | IA |
N | 207RC0000X | Internist - Cardiovascular Disease | 036.133511 | IL |
Y | 207RI0011X | Interventional Cardiology | 35.136409 | OH |
NPI | 1093022451 |
---|---|
Provider Name | Yohannes Bayissa |
First Address | Dublin, OH 43016-4141 |
Second Address | Mansfield, OH 44903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2010 |
Last Update Date | 01/07/2019 |