Individual
MIKIYAS FITAWOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Contact information
Practice address
302 SAMUEL DR APT 218, MADISON, WI 53717-2216
(202) 629-6468
Mailing address
302 SAMUEL DR APT 218, MADISON, WI 53717-2216
(202) 629-6468
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
193-17
WI
367H00000X
Anesthesiologist Assistant
75000194A
IN
Other
Enumeration date
07/21/2021
Last updated
11/08/2024
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