Individual
DAWIT TESFAY HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 COFFEE RD, MODESTO, CA 95355-2803
(209) 526-4500
Mailing address
3158 W MASTER ST, PHILADELPHIA, PA 19121-4423
(202) 520-6532
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A195369
CA
390200000X
Student in an Organized Health Care Education/Training Program
MT220191
PA
Other
Enumeration date
05/28/2020
Last updated
06/26/2024
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