Provider Demographics
NPI:1306541206
Name:DEMOZ, ASMERET TESFAGHIORGISH (MD)
Entity type:Individual
Prefix:
First Name:ASMERET
Middle Name:TESFAGHIORGISH
Last Name:DEMOZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 ALCATRAZ AVE APT 16
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2746
Mailing Address - Country:US
Mailing Address - Phone:510-944-6954
Mailing Address - Fax:
Practice Address - Street 1:1826 ALCATRAZ AVE APT 16
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2746
Practice Address - Country:US
Practice Address - Phone:510-944-6954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program