Individual
DR. GHEBRU W WOLDEMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2851 S AVE B, SUITE 2601, YUMA, AZ 85364-7726
(928) 317-9562
(928) 726-1588
Mailing address
2851 S AVE B, SUITE 2601, YUMA, AZ 85364-7726
(928) 317-9562
(928) 726-1588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31647
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004053776
AETNA
AZ
05
—
836025
—
AZ
01
—
AZ0735990
BCBS
AZ
Enumeration date
12/26/2006
Last updated
07/01/2011
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