Individual
SAMSON DEJENE TADESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-6000
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-6000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
75162
GA
208M00000X
Hospitalist Physician
Primary
075162
GA
Other
Enumeration date
06/26/2013
Last updated
11/16/2020
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