Gizachew Asefa Seyoum

Primary specialty

PharmacistTaxonomy code 183500000X

License

0000035837 Issued in TN

Practice address

856 Highway 411 N
Etowah, TN 37331-1912

Phone

(423) 263-5656

Fax

(423) 263-1803

NPI assigned

Oct 16, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318723200000",
    "number": "1700161247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 GERMANTOWN CIR",
            "address_2": "APT # 919",
            "city": "EAST RIDGE",
            "state": "TN",
            "postal_code": "374121861",
            "telephone_number": "615-275-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 HIGHWAY 411 N",
            "city": "ETOWAH",
            "state": "TN",
            "postal_code": "373311912",
            "telephone_number": "423-263-5656",
            "fax_number": "423-263-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEYOUM",
        "first_name": "GIZACHEW",
        "middle_name": "ASEFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-16",
        "last_updated": "2011-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "0000035837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Etowah, TN
• Providers in Etowah, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2011; 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.