# DR AFEWORKI KIDANE LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366462764
- **Authorized official:** AFEWORKI OCBAGHIORGIS KIDANE DO (PRESIDENT)
- **Authorized official phone:** (480) 653-8400

## Contact information

- **Practice address:** 6641 E BAYWOOD AVE, MESA, AZ 85206-1723
- **Practice address phone:** (480) 653-8400
- **Practice address fax:** (480) 209-1337
- **Mailing address:** 6641 E BAYWOOD AVE, MESA, AZ 85206-1723
- **Mailing address phone:** (480) 653-8400
- **Mailing address fax:** (480) 209-1337

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 4458 | AZ | Yes |
| 207R00000X | Internal Medicine Physician | 5101012760 | MI | — |
| 261Q00000X | Clinic/Center | 4458 | AZ | — |

## Other

- **Enumeration date:** 07/20/2006
- **Last updated:** 05/08/2018