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General NPI Number Information
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NPI Number | 1033669445
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Entity Type | Organization
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Legal Business Name | T-BEYENE HYPERTENSION & KIDNEY CARE PLC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 4160 JOHN R STE 1011 HARPER PROFESSIONAL BUILDING
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-341-1431
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Fax |
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Provider Business Mailing Address
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Address Line | 4572 RANCH LN
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-2440
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Country | US
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Telephone | 773-209-3378
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Fax | 248-595-8269
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TADESSE BEYENE
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Credential | M.D.
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Telephone | 773-209-3378
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 4301092774
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License Number State | MI
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