Individual
BENYAM GOITOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(925) 457-6777
Mailing address
1501 N CAMPBELL AVE., PO BOX 245058, TUCSON, AZ 85724
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
R78017
NY
208600000X
Surgery Physician
R78017
AZ
Other
Enumeration date
04/24/2020
Last updated
07/19/2021
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