Healthcare Provider Details

I. General information

NPI: 1205288818
Provider Name (Legal Business Name): MAHALET ZEWDE WELDE SEMAT M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2016
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2447 VALLEJO ST APT 5
SAN FRANCISCO CA
94123-4656
US

IV. Provider business mailing address

PO BOX 1750 HOSPITAL BELLA VISTA
MAYAGUEZ PR
00681
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6000
  • Fax: 787-652-6032
Mailing address:
  • Phone: 787-834-2350
  • Fax: 787-652-6032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number19009
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: