Tewodros Fesseha, M.D., P.C.

LBN: Tewodros Fesseha, M.D., P.C.
Tewodros Fesseha, M.D., P.C. is an health care organization with primary practice located at 20905 Greenfield Rd Suite 407, Southfield MI 48075-5360. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Tewodros Fesseha, M.D., P.C. can be contacted via phone (248) 552-8525, or through Fesseha, Tewodros via phone (248) 552-8525.

Contact Information

Primary practice address
20905 Greenfield Rd Suite 407 Southfield MI 48075-5360
Phone: (248) 552-8525
Fax: (248) 552-1134
Website:
Map and Directions
Authorized official contact:
Name: Fesseha, Tewodros Doctor of Medicine (MD)
Phone: (248) 552-8525

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 4101056254 Michigan

Profile Details

NPI number 1578750006
LBN Legal business name Tewodros Fesseha, M.D., P.C.
DBA Doing business as
Authorized official Fesseha, Tewodros Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 28th, 2007
Last updated Sep 28th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578750006 NPPES
Michigan Other 3406311902 BLUE CROSS
Michigan MEDICAID 4132714 10 BLUE CROSS

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