Individual
BETELHEM DEBEBE YIFRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13250 WASHINGTON AVE, MT PLEASANT, WI 53177-1516
(262) 799-8700
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
81530-20
WI
208M00000X
Hospitalist Physician
Primary
81530
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100293600
—
WI
Enumeration date
03/24/2021
Last updated
11/19/2024
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