Individual
DR. ANDENET MENGISTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-4820
Mailing address
1600 MEDICAL CENTER DR, HUNTINGTON, WV 25701-3656
(304) 691-1824
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
T-5943
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2021
Last updated
07/23/2025
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