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GIRUM L LEMMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6025 LAKE RD STE 110, WOODBURY, MN 55125-1709
(651) 735-7414
(651) 735-1827
Mailing address
2550 UNIVERSITY AVE W STE 110N, SAINT PAUL, MN 55114-2001
(651) 602-5311
(651) 222-6786

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
52821
MN
208M00000X
Hospitalist Physician
01062226A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000485519
ANTHEM PROVIDER NUMBER
IN
05
200827030
IN
01
9450969
PHCS PID NUMBER
IN
Enumeration date
05/24/2006
Last updated
02/21/2018
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