Provider Demographics
NPI:1457353153
Name:FREW, MULUKEN DEMESSIE (MD)
Entity type:Individual
Prefix:DR
First Name:MULUKEN
Middle Name:DEMESSIE
Last Name:FREW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1821 WINN ARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33594-4543
Mailing Address - Country:US
Mailing Address - Phone:813-352-9442
Mailing Address - Fax:813-872-2775
Practice Address - Street 1:2912 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1855
Practice Address - Country:US
Practice Address - Phone:813-443-4611
Practice Address - Fax:813-443-4754
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2016-02-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME88205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine