Individual
MEKEDESE TESFAYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1617 SATILLA BLVD, WAYCROSS, GA 31501-5027
(404) 642-7838
Mailing address
3275 HARRIS RD, WAYCROSS, GA 31503-8956
(912) 287-5801
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006805
GA
Other
Enumeration date
02/21/2014
Last updated
02/21/2014
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