Individual
EYOB A. AMDEMICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
101255547
VA
207R00000X
Internal Medicine Physician
12986
ND
207R00000X
Internal Medicine Physician
256979
MA
207R00000X
Internal Medicine Physician
56794
MN
207R00000X
Internal Medicine Physician
D0077556
MD
207R00000X
Internal Medicine Physician
Primary
MD2013-0563
NM
207R00000X
Internal Medicine Physician
MD449260
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326011YS5Y
MEDICARE
NM
05
—
64081770
—
NM
Enumeration date
08/11/2010
Last updated
10/17/2014
Update your record
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