Individual
YARED BERHANU HAILEMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 KRESGE WAY STE 60, LOUISVILLE, KY 40207-4690
(502) 893-7710
(502) 893-1391
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
48993
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48993
MEDICAL LICENSE
KY
Enumeration date
06/24/2011
Last updated
12/09/2020
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