Provider Demographics
NPI:1508907742
Name:EMBAYE, TEAME HADGU (DC)
Entity Type:Individual
Prefix:DR
First Name:TEAME
Middle Name:HADGU
Last Name:EMBAYE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 E FRANKLIN AVE
Mailing Address - Street 2:# 2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1795
Mailing Address - Country:US
Mailing Address - Phone:612-343-8994
Mailing Address - Fax:612-343-8995
Practice Address - Street 1:2327 E FRANKLIN AVE
Practice Address - Street 2:# 2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1795
Practice Address - Country:US
Practice Address - Phone:612-343-8994
Practice Address - Fax:612-343-8995
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3513111N00000X
VA1904111N00000X
DCCH030060111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN26G4 2 EMOtherBLUECROSS BLUESHIELD