Individual
MAHTEME SELASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04944
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141971
VALUE OPTIONS
MD
01
—
2129679
MAMSI/ALLIANCE
MD
01
—
567898
NCPPO
MD
01
—
583BMA
BLUE CROSS
MD
01
—
M5790001
BLUE CROSS
DC
Enumeration date
06/24/2005
Last updated
07/13/2026
Update your record
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