Provider Demographics
NPI:1326019142
Name:ASSEFA, GETU (MD)
Entity Type:Individual
Prefix:DR
First Name:GETU
Middle Name:
Last Name:ASSEFA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 CRESTVIEW PARK DR STE 209
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2856
Mailing Address - Country:US
Mailing Address - Phone:615-446-5121
Mailing Address - Fax:615-446-1359
Practice Address - Street 1:113 HIGHWAY 70 E FL 3
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-2075
Practice Address - Country:US
Practice Address - Phone:615-446-1345
Practice Address - Fax:615-441-4560
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY44784207RC0000X, 207RI0011X
TN55032207RI0011X
MDD0062679207RC0000X
VA0101230963207RC0000X
DCMD32922207R00000X
PAMD435987207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ073826Medicaid
KY7100197410Medicaid
KYP01024688OtherRR MEDICARE
KYK031820Medicare PIN
H96004Medicare UPIN
KYK031821Medicare PIN