Individual
TESFAY MEZGEBE HAILU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13350 N 94TH DR STE A101, PEORIA, AZ 85381-4826
(623) 974-1500
Mailing address
2700 SHANANDALE DR, SILVER SPRING, MD 20904-1632
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
7946
AZ
Other
Enumeration date
05/07/2020
Last updated
04/01/2022
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