Individual
MR. MEDHANIE KIFLE KIFLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1320 W MAIN ST, NEWARK, OH 43055
(740) 348-4137
(740) 348-4119
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003744
OH
363A00000X
Physician Assistant
Primary
PA2017-0013
NM
Other
Enumeration date
05/09/2013
Last updated
02/21/2019
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