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Individual

DR. ANTENEH K FISSEHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
600 MARY STREET, EVANSVILLE, IN 47747-4379
(812) 450-3036
(812) 450-2193
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-3036
(812) 450-2193

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP61302801
WA
208M00000X
Hospitalist Physician
Primary
02007470A
IN
208M00000X
Hospitalist Physician
OP61302801
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154881175
WA
Enumeration date
03/25/2019
Last updated
09/27/2023
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