Individual
DR. TAKELE TILAYE DEMESILASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
677 CHURCH ST NE # 111, MARIETTA, GA 30060-1101
(770) 793-7750
Mailing address
677 CHURCH ST NE # 111, MARIETTA, GA 30060-1101
(770) 793-7750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4185
GA
208M00000X
Hospitalist Physician
Primary
069183
GA
Other
Enumeration date
07/02/2010
Last updated
10/02/2019
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