Individual
DEREJE SEYOUM LEGESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
745 POPLAR RD, NEWNAN, GA 30265-1618
(770) 400-2353
Mailing address
3041 CEDAR CREEK PKWY, DECATUR, GA 30033-4415
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
99350
GA
208M00000X
Hospitalist Physician
99350
GA
Other
Enumeration date
05/13/2020
Last updated
09/10/2024
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