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TEWODROS FESSEHA MD NPI 1225098783


NPI Information

NPI: 1225098783
Provider Name: TEWODROS FESSEHA, MD
Classification: Urology - 208800000X
Entity Type: Individual

PECOS Registration: Yes

Address:
22255 GREENFIELD RD
SUITE 240
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 552-8525
Get Directions

Tewodros Fesseha, MD is an urology in Southfield, MI. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. Tewodros Fesseha, MD NPI is 1225098783. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22255 GREENFIELD RD
SUITE 240
SOUTHFIELD, MI
ZIP 48075-710
Phone: (248) 552-8525
Fax: (248) 552-1134

The NPI 1225098783 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 10/2/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrology4301056254MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1N98330001MEDICARE ID-TYPE UNSPECIFIEDMICHIGAN
2413271410MEDICAIDMICHIGAN
3G14998MEDICARE UPIN
434063119028OTHERMICHIGANBCBSM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.