| Provider / Organization | NPI | Date Certified |
|---|---|---|
| BENIAM TEFERA ABEBE | 1336623222 | 2022-05-08 |
Beniam Tefera Abebe [M] graduated in 2018 from Duke University School Of Medicine and primarily specializes in Physician Assistant.
Beniam Tefera Abebe is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1336623222. Registration indicates Beniam Tefera Abebe is a provider of services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant: Surgical, ) (All Other Specialties & Provider Types, ) (Physician Assistant Surgical Technologist, Physician Assistants & Advanced Practice Nursing Providers) (Physician Assistant, )
| PECOS ID | 9133473879 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Beniam Tefera Abebe PA-C |
| Practice Office Address | 5730 GLENRIDGE DR STE 200 ATLANTA, GA US |
| Practice Office Telephone | 4042525206 |
| Mailing Address | 1561 JANMAR RD SNELLVILLE, GA 300785639 US |
| Business Telephone | 6783448900 |
| Business Fax | 6786665201 |
| Code | Practice | License No State |
|---|---|---|
| 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant |
GA |
| 363AS0400X PRIMARY | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant Physician Assistant: Surgical All Other Specialties & Provider Types Physician Assistant Surgical Technologist Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | 8985
GA |