MEDICARE: DR. SOSENA KEBEDE 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	2003-00820	NC

General Provider Information

NPI Number	:	1790780195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SOSENA KEBEDE MD

Provider Business Mailing Address
First Line	:	6455 BEST FRIEND RD
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-2914
Country	:	US
Telephone Number	:	770-754-5150
Fax Number	:	678-762-4098

Provider Business Practice Location Address
First Line	:	6455 BEST FRIEND RD
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-2914
Country	:	US
Telephone Number	:	770-754-5150
Fax Number	:	678-762-4098

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	06/13/2025

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