1780769083

Everything you always wanted to know about BELAY M ANTENEH MD but were afraid to ask.

BELAY M ANTENEH MD

You can also download the this 1780769083 data report as csv | excel | json | xml
Provider Last Name Provider Middle Name Provider First Name Provider Credential
BELAY M ANTENEH MD
Gender:
Male
Enumeration date:
2006-10-26
Last update date:
2008-11-17
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
010345197 Medicaid none VA
P00370390 Other RAILROAD MEDICARE VA

Taxonomies

Taxonomy State License Number Primary?
207P00000X Emergency Medicine VA 0101240085 Y

Phone Numbers

Type Number
Practice Location Address Telephone Number 7036701313
Practice Location Address Fax Number 9043460113
Mailing Address Telephone Number 7038888259

Addresses

Type Address City State Postal Country
Mailing Address 1820 SOUTHMORE BLVD HOUSTON TX 77004 TX
Practice Location Address 2300 OPITZ BLVD UNIT D. WOODBRIDGE VA 0 VA

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Individual
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Organization
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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