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NPI Code Detail

MEDICARE: MERON A TESFAY M.D.

MEDICARE:   MERON A TESFAY  M.D.
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
1207RG0100XGastroenterology PhysicianR8498TX
2207RG0100XGastroenterology Physician01098585AIN
3207RG0100XGastroenterology Physician90581SC
4207RG0100XGastroenterology Physician88554GA

General Provider Information

NPI Number : 1356603914
Entity Type Code : Individual
Provider Name (Legal Business Name) : MERON A TESFAY M.D.
Provider Business Mailing Address
First Line : 1979 SIMPSON RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-4803
Country : US
Telephone Number : 707-262-6517
Fax Number :
Provider Business Practice Location Address
First Line : 805 PAMPLICO HWY
Second Line :
City : FLORENCE
State : SC
Zip : 29505-6047
Country : US
Telephone Number : 843-674-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2012
Last Update Date : 05/18/2026

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Directions to “ MERON A TESFAY M.D.” Practice Location

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