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GETACHEW DESTA IYASU M.D

>> Internal Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1184064867

Individual Registrant:
 GETACHEW DESTA IYASU M.D
Gender: M
Not Sole Proprietor

Location and contact information for practice:
743 SPRING STREET NE  GAINSVILLE, GA 30501 US
Tel: 770-219-6000  Fax: --

Contact information for business:
PO BOX 742616  ATLANTA, GA 30374-2616 US
Tel: 770-219-8420  Fax: --

Registration Information:
NPI: 1184064867
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N207R00000XAllopathic & Osteopathic Physicians
Internal Medicine
GA006551
Y208M00000XAllopathic & Osteopathic Physicians
Hospitalist
GA74871

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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