Individual
MERON ANBESAW SELASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-1177
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MT199003
PA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
51337
SC
390200000X
Student in an Organized Health Care Education/Training Program
MT199003
PA
Other
Enumeration date
04/25/2011
Last updated
07/21/2022
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