Demissachew, Hailu

Demissachew, Hailu is an individual health care provider with primary practice located at 19 Redmond Rd Nw , Rome GA 30165-1533. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Demissachew, Hailu can be contacted via phone (706) 233-8504.

Contact Information

Primary practice address
19 Redmond Rd Nw Rome GA 30165-1533
Phone: (706) 233-8504
Fax: (706) 233-8505
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 054072 Georgia

Profile Details

NPI number 1356401616
LBN Legal business name Demissachew, Hailu
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2006
Last updated Mar 23rd, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356401616 NPPES
Georgia MEDICAID 413486161A
Georgia MEDICAID 413486161G
Georgia MEDICAID 413486161D
Georgia MEDICAID 413486161E
Georgia MEDICAID 413486161B
Georgia MEDICAID 413486161C
Georgia MEDICAID 413486161F
Georgia MEDICAID 413486161H

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