Organization
DR AFEWORKI KIDANE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AFEWORKI OCBAGHIORGIS KIDANE DO (PRESIDENT)
(480) 653-8400
Entity
Organization
Contact information
Practice address
6641 E BAYWOOD AVE, MESA, AZ 85206-1723
(480) 653-8400
(480) 209-1337
Mailing address
6641 E BAYWOOD AVE, MESA, AZ 85206-1723
(480) 653-8400
(480) 209-1337
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
4458
AZ
207R00000X
Internal Medicine Physician
5101012760
MI
261Q00000X
Clinic/Center
4458
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168550
ACCCS AZ
—
05
—
3480230
—
MI
Enumeration date
07/20/2006
Last updated
05/08/2018
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