Individual
DR. ZEWDU LISSANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 GREENBRIAR DR, CAMPBELLSVILLE, KY 42718-9616
(270) 789-0247
Mailing address
1698 OLD LEBANON RD, CAMPBELLSVILLE, KY 42718-9662
(270) 789-0247
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
36828
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64032188
—
KY
Enumeration date
02/07/2006
Last updated
12/11/2013
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