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General NPI Number Information
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NPI Number | 1780983320
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Entity Type | Individual
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Provider Name | NEBIYU Y BIRU M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 04/26/2023
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Provider Practice Location Address
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Address Line | 3400 UNION AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-8426
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Country | US
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Telephone | 920-828-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 4902 DONOVAN DR
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City | ALEXANDRIA
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State | VA
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Zip | 22304-8606
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Country | US
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Telephone | 732-939-7248
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 0101258331
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 57607
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0101258331
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 57607
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License Number State | WI
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