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NPI Code Detail

MEDICARE: MERON FESSEHAYE MD

MEDICARE: MERON FESSEHAYE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1114621703
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERON FESSEHAYE MD
Provider Business Mailing Address
First Line : 1801 ROZZELLES FERRY RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-4228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1801 ROZZELLES FERRY RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28208-4228
Country : US
Telephone Number : 704-446-9987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2023
Last Update Date : 05/06/2026

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Directions to “ MERON FESSEHAYE MD” Practice Location

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