Individual
DEREJE KENO GEMECHU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5924 DUPONT AVE N, MINNEAPOLIS, MN 55430-2748
(612) 453-5217
Mailing address
5924 DUPONT AVE N, MINNEAPOLIS, MN 55430-2748
(612) 453-5217
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
Y000030138200
MN
Other
Enumeration date
09/16/2025
Last updated
09/16/2025
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