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General NPI Number Information
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NPI Number | 1649463506
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Entity Type | Organization
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Legal Business Name | RED SEA HEART CENTER PLC
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 610 W CATALINA DR
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City | YUMA
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State | AZ
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Zip | 85364-8011
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Country | US
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Telephone | 928-344-9300
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Fax | 928-344-9304
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Provider Business Mailing Address
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Address Line | 610 W CATALINA DR
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City | YUMA
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State | AZ
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Zip | 85364-8011
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Country | US
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Telephone | 928-344-9300
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Fax | 928-344-9304
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Authorized Official
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Title or Position | MD/OWNER
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Name | DR. HABTEAB BETSUAMLAC FESEHA
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Credential | MD
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Telephone | 928-344-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 37118
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License Number State | AZ
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