Organization
MENGISTU YEMANE MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MENGISTU YEMANE M.D. (DR/ PRESIDENT)
(606) 451-8644
Entity
Organization
Contact information
Practice address
30 TOWER CIR, SOMERSET, KY 42503-3476
(606) 451-8644
(606) 451-9644
Mailing address
30 TOWER CIR, SOMERSET, KY 42503-3476
(606) 451-8644
(606) 451-9644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38234
KY
363L00000X
Nurse Practitioner
4821P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64066574
—
KY
01
—
DH2005
RR MDC
KY
Enumeration date
09/12/2007
Last updated
12/01/2010
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