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TEWODROS FESSEHA M.D. P.C. NPI 1578750006


NPI Information

NPI: 1578750006
Provider Name: TEWODROS FESSEHA, M.D., P.C.
Classification: Urology - 208800000X
Entity Type: Organization
Address:
20905 GREENFIELD RD
SUITE 407
SOUTHFIELD, MI
ZIP 48075
Phone: (248) 552-8525
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TEWODROS FESSEHA, M.D., P.C. 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, M.D., P.C. NPI is 1578750006. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

20905 GREENFIELD RD
SUITE 407
SOUTHFIELD, MI
ZIP 48075-360
Phone: (248) 552-8525
Fax: (248) 552-1134

The provider's authorized official is Tewodros Fesseha .
The authorized official title is President and has the following contact phone number (248) 552-8525.

The enumeration date for this NPI number is 9/28/2007 and was last updated on 9/28/2007.


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
1208800000XUrology4101056254MICHIGANYes

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
14132714 10MEDICAIDMICHIGAN
23406311902OTHERMICHIGANBLUE CROSS
30N98330MEDICARE PINMICHIGAN

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: 11/14/2023

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