Individual
DR. DEGESEW ANDUALEM BEZZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 751-5087
Mailing address
2401 W UNIVERSITY AVE, ATT: QUADREA SLAVENS, MUNCIE, IN 47303-3428
(765) 747-3064
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01071042A
IN
208M00000X
Hospitalist Physician
01071042A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000766991
ANTHEM BCBS
IN
05
—
201067970
—
IN
01
—
P01120499
RAILROAD MEDICARE
IN
Enumeration date
09/13/2010
Last updated
03/14/2024
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