Kidanu Birhanu, M.D.
Internal Medicine in Dyer, IN. Individual provider (NPI-1).
NPI number1710073952
StatusActive
Last updated in NPPESMar 30, 2016
Details
- NPI
- 1710073952
- Entity type
- Individual (NPI-1)
- Name
- Kidanu Birhanu
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 5, 2006
- Last updated
- Mar 30, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 01066132 | IN | Yes |
| 207R00000X | Internal Medicine | 036072060 | IL |
Other names
- Kidanu Birhanu (Professional Name)
Practice location
24 Joliet StSte 302
Dyer, IN 46311-1705
Phone 219-852-2518 · Fax 219-864-2156
Mailing address
24 Joliet StSte 302
Dyer, IN 46311-1705
Phone 219-852-2518 · Fax 219-864-2156
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