Individual
ANTENEH BIRRU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3273
Mailing address
975 E 3RD ST, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-2147
(423) 661-7718
(423) 778-2108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
54646
TN
208M00000X
Hospitalist Physician
54646
TN
208M00000X
Hospitalist Physician
90695
GA
Other
Enumeration date
06/20/2013
Last updated
01/05/2024
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