Provider Demographics
NPI:1174910491
Name:HAILEMARIAM, YEHUALASHET BEKELE (MD)
Entity type:Individual
Prefix:DR
First Name:YEHUALASHET
Middle Name:BEKELE
Last Name:HAILEMARIAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:YEHUALASHET
Other - Middle Name:BEKELE
Other - Last Name:HAILEMARIAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:676 HOLLAND RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086-4266
Mailing Address - Country:US
Mailing Address - Phone:615-810-4013
Mailing Address - Fax:
Practice Address - Street 1:1411 W BADDOUR PKWY,LEBANON TN 37087
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087
Practice Address - Country:US
Practice Address - Phone:615-444-8262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000057086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine