Ghebremeskel, Yacob

Ghebremeskel, Yacob is an individual health care provider with primary practice located at 3950 Austell Rd Box 22, Austell GA 30106-1121. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Ghebremeskel, Yacob can be contacted via phone (470) 732-4022.

Contact Information

Primary practice address
3950 Austell Rd Box 22 Austell GA 30106-1121
Phone: (470) 732-4022
Fax: (470) 732-4023
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 45801 Georgia
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 045801 Georgia

Profile Details

NPI number 1780765776
LBN Legal business name Ghebremeskel, Yacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Sep 26th, 2019 - 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 1780765776 NPPES
Georgia Other 200287929 FEDERAL TAX ID
Georgia MEDICAID 000799719D FEDERAL TAX ID

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