Provider Demographics
NPI:1922459700
Name:ALEMAYEHU, MARTHA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:
Last Name:ALEMAYEHU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 S 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7110
Mailing Address - Country:US
Mailing Address - Phone:928-341-0700
Mailing Address - Fax:
Practice Address - Street 1:2775 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7110
Practice Address - Country:US
Practice Address - Phone:928-341-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008160207R00000X
AZ1908 R 75851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine