Tesfaye, Tassew

Tesfaye, Tassew is an sole proprietor health care provider with primary practice located at 4958 Memorial Dr , Stone Mountain GA 30083-4148. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Tesfaye, Tassew can be contacted via phone (404) 809-2480.

Contact Information

Primary practice address
4958 Memorial Dr Stone Mountain GA 30083-4148
Phone: (404) 809-2480
Fax: (404) 809-2485
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 047542 Georgia

Profile Details

NPI number 1710974696
LBN Legal business name Tesfaye, Tassew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2005
Last updated May 23rd, 2012 - about 13 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 1710974696 NPPES
Georgia MEDICAID 000870405C

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