Individual
ASSEFA AYALEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-0000
Mailing address
2355 HIGHWAY 36 W STE 100, ROSEVILLE, MN 55113-3905
(651) 292-0000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
58291
MN
2085R0202X
Diagnostic Radiology Physician
D85446
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912240235
NPI
MN
01
—
D85446
MEDICAL
MD
Enumeration date
04/04/2013
Last updated
07/07/2021
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