Provider Demographics
NPI:1871876946
Name:TESFAYE, FIKRE SEYOUM (PHARMD)
Entity type:Individual
Prefix:
First Name:FIKRE
Middle Name:SEYOUM
Last Name:TESFAYE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5982 S HELENA ST
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1036
Mailing Address - Country:US
Mailing Address - Phone:303-690-6738
Mailing Address - Fax:
Practice Address - Street 1:16440 E ARAPAHOE RD
Practice Address - Street 2:
Practice Address - City:FOXFIELD
Practice Address - State:CO
Practice Address - Zip Code:80016-1514
Practice Address - Country:US
Practice Address - Phone:303-928-8064
Practice Address - Fax:303-928-8070
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16185183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist