Healthcare Provider Details

I. General information

NPI: 1013265578
Provider Name (Legal Business Name): BEZA TESHOME TAYACHEW MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BEZA JOBIRA

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12631 E 17TH AVE
AURORA CO
80045-2527
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 303-724-1784
  • Fax:
Mailing address:
  • Phone: 970-624-4127
  • Fax: 970-490-4173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.0075820
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: