Healthcare Provider Details
I. General information
NPI: 1194526236
Provider Name (Legal Business Name): YONAS GEBEYEHU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/24/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 SUSHRUTA DR
MARTINSBURG WV
25401-8876
US
IV. Provider business mailing address
1002 SUSHRUTA DR
MARTINSBURG WV
25401-8876
US
V. Phone/Fax
- Phone: 304-263-0913
- Fax: 304-267-2917
- Phone: 304-263-0913
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: