Individual
DR. TESFAYE TELILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
080997
GA
207RC0000X
Cardiovascular Disease Physician
080997
GA
207RI0011X
Interventional Cardiology Physician
Primary
080997
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125060332
STATE OF ILLINOIS
IL
Enumeration date
08/08/2011
Last updated
08/07/2018
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