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NPI Code Detail

MEDICARE: MEKDEM TESFAYE MD

MEDICARE:   MEKDEM  TESFAYE  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 Program182328NC

General Provider Information

NPI Number : 1235499708
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEKDEM TESFAYE MD
Provider Business Mailing Address
First Line : PEDIATRIC EDUCATION OFC
Second Line : CB 7593
City : CHAPEL HILL
State : NC
Zip : 27599-0001
Country : US
Telephone Number : 919-966-6669
Fax Number :
Provider Business Practice Location Address
First Line : PEDIATRIC EDUCATION OFC
Second Line : CB 7593
City : CHAPEL HILL
State : NC
Zip : 27599-0001
Country : US
Telephone Number : 919-966-6669
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2012
Last Update Date : 05/18/2012

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Directions to “ MEKDEM TESFAYE MD” Practice Location

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