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Contact Information

TESFAYE D FANTA, MD
910 WEST HARRISON STREET
REIDSVILLE, NC27320
 Phone: 336-342-9564
 Fax: 336-349-9723
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for TESFAYE D FANTA · (Male)

NPI Number 1174557128
Status Active
Credentials MD
Entity Individual
Enumeration date 07/10/2006
Last updated 07/26/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 9700943
  • NC Medicaid 891066A
Hospital affiliation(s)
  • MOREHEAD MEMORIAL HOSPITAL - (Acute Care)
    117 E KINGS HIGHWAY
    EDEN, NC 27288
  • MOSES H CONE MEMORIAL HOSPITAL THE - (Acute Care)
    1200 N ELM ST
    GREENSBORO, NC 27401
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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