Individual
TAMIRAT EDIE FEKENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 S WOODS MILL RD, CHESTERFIELD, MO 63017-3625
(314) 205-6050
(314) 434-5939
Mailing address
5826 104TH ST, LUBBOCK, TX 79424-8282
(206) 430-8671
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2018012258
MO
207R00000X
Internal Medicine Physician
Primary
MD2022-0215
NM
Other
Enumeration date
06/11/2018
Last updated
03/13/2024
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