Individual
KALKIDAN GENETE BISHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Mailing address
MSS 6AV1-PE, 400 EAST THIRD STREET, DULUTH, MN 55805-1951
(218) 786-3146
(218) 722-8972
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
52162
MN
207RI0011X
Interventional Cardiology Physician
Primary
52162
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P01021775
RAILROAD MEDICARE
MN
Enumeration date
08/22/2007
Last updated
06/29/2020
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