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Individual

MS. MISGANA MESFIN BELEGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001005631
NC
363AS0400X
Surgical Physician Assistant
Primary
PA030536
MD
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1487813465
1487813465
Enumeration date
06/05/2008
Last updated
11/05/2019
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