Individual
DR. FREAW NIGUSSIE DEJENIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3900 ST FRANCIS WAY STE 213, LAFAYETTE, IN 47905-4938
(765) 775-2800
(765) 471-5461
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101246521
VA
207R00000X
Internal Medicine Physician
MD038406
DC
207RG0100X
Gastroenterology Physician
Primary
01073022A
IN
207RG0100X
Gastroenterology Physician
105556
GA
207RG0100X
Gastroenterology Physician
D70682
MD
208M00000X
Hospitalist Physician
MD038406
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266180L95
MEDICARE PIN
—
Enumeration date
06/02/2008
Last updated
03/31/2026
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