Individual
MESFIN ETANA ABDISSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6901 W EDGERTON AVE, MILWAUKEE, WI 53220-4420
(414) 423-5179
Mailing address
1000 DEVONSHIRE LN APT A116, A116, BLOOMINGTON, MN 55431-5032
(240) 893-7484
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48957
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34871300
—
WI
Enumeration date
06/23/2006
Last updated
03/07/2023
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