Tesfaye MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TESFAYE MD

Practice address

4045 Royal Pennon CT
Norcross, GA 30092-2178

Phone

(770) 474-5470

Fax

(770) 474-4620

NPI assigned

Sep 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tassew Tesfaye, MD

Title

Ceo/Owner

Phone

(770) 474-5470

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190592000000",
    "number": "1487840468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 ROYAL PENNON CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922178",
            "telephone_number": "770-474-5470",
            "fax_number": "770-474-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 ROYAL PENNON CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922178",
            "telephone_number": "770-474-5470",
            "fax_number": "770-474-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TESFAYE MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2007-09-24",
        "status": "A",
        "authorized_official_last_name": "TESFAYE",
        "authorized_official_first_name": "TASSEW",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "770-474-5470",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.