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1023064938

NPI Code Detail

MEDICARE: ABIY DESSALEGN MEKOYA MD

MEDICARE: ABIY DESSALEGN MEKOYA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	47598	WI
2	208M00000X	Hospitalist Physician	58369	GA
3	207R00000X	Internal Medicine Physician	58369	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023064938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIY DESSALEGN MEKOYA MD

Provider Business Mailing Address
First Line	:	PO BOX 1705
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30903-1705
Country	:	US
Telephone Number	:	706-774-7263
Fax Number	:	706-774-7230

Provider Business Practice Location Address
First Line	:	2260 WRIGHTSBORO RD
Second Line	:
City	:	AUGUSTA
State	:	GA
Zip	:	30904-4764
Country	:	US
Telephone Number	:	706-774-5795
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	05/21/2024

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Directions to “ ABIY DESSALEGN MEKOYA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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