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General NPI Number Information
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NPI Number | 1467816561
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Entity Type | Individual
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Provider Name | GIRMA TESFAYE BEYENE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 12/24/2025
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Provider Practice Location Address
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Address Line | 1255 HIGHWAY 54 W
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-4526
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Country | US
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Telephone | 770-719-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 3237 S 16TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53215-4526
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 71308
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 105095
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 105095
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License Number State | GA
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