Individual
NEBIYU Y BIRU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 UNION AVE, SHEBOYGAN, WI 53081-8426
(920) 828-2700
Mailing address
4902 DONOVAN DR, ALEXANDRIA, VA 22304-8606
(732) 939-7248
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
0101258331
VA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
57607
WI
207RP1001X
Pulmonary Disease Physician
0101258331
VA
207RP1001X
Pulmonary Disease Physician
Primary
57607
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031133
—
WI
Enumeration date
03/22/2011
Last updated
04/26/2023
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