Organization · Type 2 NPI
Kidanu Birhanu MD SC
Clinic/Center · Dyer, IN
NPI number
1619288339
Active
Practice location
24 Joliet St, Suite 302
Dyer, IN 46311-1705
Fax (219) 864-2156
Mailing address
PO Box 394
Dyer, IN 46311-0394
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | 01066132A (IN) |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
111 other providers at this address
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Other clinic/center providers in Dyer
About NPI 1619288339
Kidanu Birhanu MD SC's National Provider Identifier is 1619288339, issued on Jun 28, 2010. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Dyer, IN. The record was last updated on Jun 28, 2010.