Individual
DR. MAKONNEN G. HABTEMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1800 E VAN BUREN ST, PHOENIX, AZ 85006-3742
(602) 251-8100
(480) 907-7097
Mailing address
P.O. BOX 11773, CHANDLER, AZ 85248
(480) 907-7707
(480) 907-7097
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21618
AZ
208M00000X
Hospitalist Physician
21618
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21618
LICENSE
AZ
05
—
331918
—
AZ
Enumeration date
04/25/2006
Last updated
04/24/2015
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