Healthcare Provider Details

I. General information

NPI: 1215240460
Provider Name (Legal Business Name): SETI SEMEHARE YEMANE-BYRD D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2010
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E TRADE ST STE E484
CHARLOTTE NC
28202-2672
US

IV. Provider business mailing address

210 E TRADE ST STE E484
CHARLOTTE NC
28202-2672
US

V. Phone/Fax

Practice location:
  • Phone: 704-906-6254
  • Fax:
Mailing address:
  • Phone: 704-632-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8997
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: