Dereje Mekonnen Aboye, M.D.
Individual provider Active NPI Family Medicine Physician · Atlanta, GA
NPI 1780857243 · NPPES record last updated Apr 10, 2008
Key facts
- NPI
- 1780857243
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 41623 (KY)
- Practice address
- 720 Westview Dr SW
Morehouse School of Medicine Inc
Atlanta, GA 30310-1458 - Phone
- (404) 752-1875
- NPI assigned
- Apr 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110125001285 | GA | Practitioner - Family Practice | 6305025172 | Practice locations: Decatur, GA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41623 | KY | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 41623 | KY | Yes |
Addresses
Primary practice location
720 Westview Dr SW
Morehouse School of Medicine Inc
Atlanta, GA 30310-1458
Mailing address
720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 752-1875
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- Amiolaoluwa Oluwarotimi Abraham
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- Bisrat Kidane Abraham
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All providers in Atlanta, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.