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General NPI Number Information
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NPI Number | 1548430358
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Entity Type | Organization
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Legal Business Name | YUMA INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1773 W 24TH ST STE B
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City | YUMA
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State | AZ
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Zip | 85364-6230
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Country | US
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Telephone | 928-344-8748
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Fax | 928-341-8750
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Provider Business Mailing Address
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Address Line | 1773 W 24TH ST STE B
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City | YUMA
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State | AZ
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Zip | 85364-6230
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Country | US
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Telephone | 928-344-8748
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Fax | 928-341-8750
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Authorized Official
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Title or Position | OWNER
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Name | TSEHAYE U SEARE
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Credential | M.D.
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Telephone | 928-344-8748
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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 | 31885
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License Number State | AZ
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