Individual
TEWODROS FESSEHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22255 GREENFIELD RD, SUITE 240, SOUTHFIELD, MI 48075-3710
(248) 552-8525
(248) 552-1134
Mailing address
22255 GREENFIELD RD, SUITE 240, SOUTHFIELD, MI 48075-3710
(248) 552-8525
(248) 552-1134
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301056254
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34063119028
BCBSM
MI
05
—
413271410
—
MI
Enumeration date
03/27/2006
Last updated
10/02/2014
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