Individual
DR. EYOB TESSEMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
557 GLOVER AVE, SUITE 1, ENTERPRISE, AL 36330-2024
(334) 347-7705
(334) 347-7715
Mailing address
557 GLOVER AVE, SUITE 1, ENTERPRISE, AL 36330-2024
(334) 347-7705
(334) 347-7715
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
25331
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009932531
—
AL
05
—
009937154
—
AL
05
—
009979065
—
AL
05
—
009979865
—
AL
01
—
051000551
OSC - BCBS
AL
01
—
051000552
SPS - BCBS
AL
01
—
051530196
EBHS - BCBS
AL
01
—
051534180
TROY - BCBS
AL
Enumeration date
07/15/2006
Last updated
10/31/2012
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