Individual
TAFFERE NEGAT MIHRETU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 533-6645
(770) 535-2642
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
61295
GA
208M00000X
Hospitalist Physician
Primary
061295
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01228735
AMERIGROUP
GA
01
—
110029C049457
TRAILBLAZER
GA
01
—
2091719
CIGNA
GA
05
—
257247600A
—
GA
01
—
459354
WELLCARE
GA
01
—
52233997
BCBS
GA
01
—
9940207
AETNA
GA
Enumeration date
01/26/2008
Last updated
01/21/2009
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