Organization
ABRAHAM INFECTIOUS DISEASE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIZATCHEW KETSELA MD (OWNER)
(918) 240-5850
Entity
Organization
Contact information
Practice address
2024 E PINETREE BLVD STE H, THOMASVILLE, GA 31792-5391
(229) 236-3339
(229) 236-3337
Mailing address
2024 E PINETREE BLVD STE H, THOMASVILLE, GA 31792-5391
(229) 236-3339
(229) 236-3337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
71980
GA
Other
Enumeration date
09/19/2015
Last updated
02/20/2017
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