Provider Demographics
NPI:1245846203
Name:GETACHEW KNEE CLINIC
Entity type:Organization
Organization Name:GETACHEW KNEE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GETACHEW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-759-6838
Mailing Address - Street 1:9039 ANTARES AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4067
Mailing Address - Country:US
Mailing Address - Phone:614-987-7977
Mailing Address - Fax:614-505-6113
Practice Address - Street 1:9039 ANTARES AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4067
Practice Address - Country:US
Practice Address - Phone:614-987-7977
Practice Address - Fax:614-505-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty