Provider Demographics
NPI:1831354174
Name:TSEHAYE SEARE MD
Entity type:Organization
Organization Name:TSEHAYE SEARE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TSEHAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-344-8748
Mailing Address - Street 1:1773 W 24TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6228
Mailing Address - Country:US
Mailing Address - Phone:928-344-8748
Mailing Address - Fax:928-341-8750
Practice Address - Street 1:1773 W 24TH ST
Practice Address - Street 2:STE B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6228
Practice Address - Country:US
Practice Address - Phone:928-344-8748
Practice Address - Fax:928-341-8750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ31885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1184725798OtherINDIVIDUAL NPI
AZZ102196Medicare PIN
AZH95303Medicare UPIN