Individual provider · NPI-1
Dawit Teklemariam Antonios, MD
Hospitalist · Lithonia, GA
NPI number1063461846
StatusActive
Last updated in NPPESNov 27, 2023
Details
- NPI
- 1063461846
- Entity type
- Individual (NPI-1)
- Name
- Dawit Teklemariam Antonios
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 9, 2006
- Certification date
- Oct 28, 2020
- Last updated
- Nov 27, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | 055388 | GA | Yes |
| 207R00000X | Internal Medicine | 055388 | GA |
Practice location
2801 Dekalb Medical PkwyLithonia, GA 30058-4996
Phone 404-501-5222
Mailing address
Po Box 1170Lawrenceville, GA 30046-1170
Phone 470-325-0159 · Fax 470-325-0191
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