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General NPI Number Information
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NPI Number | 1245846203
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Entity Type | Organization
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Legal Business Name | GETACHEW KNEE CLINIC
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 10/12/2021
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Provider Practice Location Address
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Address Line | 9039 ANTARES AVE
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City | COLUMBUS
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State | OH
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Zip | 43240-4067
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Country | US
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Telephone | 614-987-7977
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Fax | 614-505-6113
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Provider Business Mailing Address
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Address Line | 9039 ANTARES AVE
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City | COLUMBUS
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State | OH
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Zip | 43240-4067
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Country | US
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Telephone | 614-987-7977
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Fax | 614-505-6113
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Authorized Official
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Title or Position | OWNER PHYSICIAN
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Name | SAMUEL GETACHEW
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Credential | M.D.
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Telephone | 440-759-6838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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