Provider Demographics
NPI:1568664860
Name:GEBREHIWOT, HAFTU K (MD)
Entity Type:Individual
Prefix:DR
First Name:HAFTU
Middle Name:K
Last Name:GEBREHIWOT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13901 E. EXPOSITION AVENUE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-2535
Mailing Address - Country:US
Mailing Address - Phone:303-364-1422
Mailing Address - Fax:303-364-1454
Practice Address - Street 1:13901 E. EXPOSITION AVENUE
Practice Address - Street 2:SUITE 230
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-2535
Practice Address - Country:US
Practice Address - Phone:303-364-1422
Practice Address - Fax:303-364-1454
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO46877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO66829810Medicaid
CO66829810Medicaid