Individual
SIMON HAILESELASSIE TESFAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3473 POPLAR AVE STE 103, MEMPHIS, TN 38111-4654
(901) 320-6915
(901) 320-6920
Mailing address
PO BOX 1000, DEPT 978, MEMPHIS, TN 38148-0001
(901) 758-9900
(901) 752-2335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41174
TN
208M00000X
Hospitalist Physician
41174
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510458
—
TN
Enumeration date
09/14/2006
Last updated
01/11/2024
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