Kidanu Birhanu Md Sc | |
24 Joliet St Suite 302 Dyer IN 46311-1705 | |
(219) 852-2518 | |
(219) 864-2156 |
Full Name | Kidanu Birhanu Md Sc |
---|---|
Speciality | Clinic/center |
Location | 24 Joliet St, Dyer, Indiana |
Authorized Official Name and Position | Kidanu Birhanu (OWNER) |
Authorized Official Contact | 7083342352 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kidanu Birhanu Md Sc Po Box 394 Dyer IN 46311-0394 Ph: (708) 334-2352 | Kidanu Birhanu Md Sc 24 Joliet St Suite 302 Dyer IN 46311-1705 Ph: (219) 852-2518 |
NPI Number | 1619288339 |
---|---|
Provider Enumeration Date | 06/28/2010 |
Last Update Date | 06/28/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619288339 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 01066132A (Indiana) | Primary |
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