| Kidanu Birhanu Md Sc | |
|
24 Joliet St Suite 302 Dyer IN 46311-1705 | |
| (219) 852-2518 | |
| (219) 864-2156 |
| Full Name | Kidanu Birhanu Md Sc |
|---|---|
| Speciality | Clinic/center |
| Location | 24 Joliet St, Dyer, Indiana |
| Authorized Official Name and Position | Kidanu Birhanu (OWNER) |
| Authorized Official Contact | 7083342352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidanu Birhanu Md Sc Po Box 394 Dyer IN 46311-0394 Ph: (708) 334-2352 | Kidanu Birhanu Md Sc 24 Joliet St Suite 302 Dyer IN 46311-1705 Ph: (219) 852-2518 |
| NPI Number | 1619288339 |
|---|---|
| Provider Enumeration Date | 06/28/2010 |
| Last Update Date | 06/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619288339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 01066132A (Indiana) | Primary |
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