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Individual
SAMUEL HAILEMARIAM FANTAYE
Active
Individual
SAMUEL HAILEMARIAM FANTAYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207QB0002X
Obesity Medicine (Family Medicine) Physician
A169452
CA
207R00000X
Internal Medicine Physician
A169452
CA
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
A169452
CA
Other
Enumeration date
05/24/2017
Last updated
10/08/2024
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