Basic Information
| Provider Information | |||||||||
| NPI: | 1477964930 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TESFAYE | ||||||||
| FirstName: | HANNA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 N SAGINAW ST | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485054452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8104064246 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2900 N SAGINAW ST | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485054452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8107875065 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2014 | ||||||||
| LastUpdateDate: | 04/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | 5101021326 | MI | N | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.