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DAWIT TEKLEMARIAM ANTONIOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2801 DEKALB MEDICAL PKWY, LITHONIA, GA 30058-4996
(404) 501-5222
Mailing address
PO BOX 1170, LAWRENCEVILLE, GA 30046-1170
(470) 325-0159
(470) 325-0191

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
055388
GA
208M00000X
Hospitalist Physician
Primary
055388
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
580618709F
GA
Enumeration date
05/09/2006
Last updated
11/27/2023
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