Individual provider · NPI-1

Anteneh M Addisu, MD

Internal Medicine · Gainesville, FL

NPI number1922052471
StatusActive
Last updated in NPPESSep 24, 2015

Details

NPI
1922052471
Entity type
Individual (NPI-1)
Name
Anteneh M Addisu
Credential
MD
Sex
Male
Sole proprietor
Yes
Enumeration date
May 20, 2006
Last updated
Sep 24, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal MedicineME75316FLYes

Practice location

1600 Sw Archer Rd
Box 100277
Gainesville, FL 32610-3003

Phone 352-265-0651

Mailing address

1600 Sw Archer Rd
Box 100277
Gainesville, FL 32610-3003

Phone 352-265-0651

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