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General NPI Number Information
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NPI Number | 1104571983
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Entity Type | Individual
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Provider Name | MAKDA MENGISTU ZEWDE RRT
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Gender | Female
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Dates
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Enumeration Date | 02/19/2022
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Last Update Date | 02/19/2022
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Provider Practice Location Address
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Address Line | 110 IRVING ST NW
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City | WASHINGTON
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State | DC
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Zip | 20010-3017
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Country | US
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Telephone | 202-877-7374
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Fax |
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Provider Business Mailing Address
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Address Line | 14405 TURBRIDGE CT
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City | BURTONSVILLE
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State | MD
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Zip | 20866-2008
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Country | US
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Telephone | 240-264-0467
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2278C0205X
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Taxonomy Name | Critical Care Certified Respiratory Therapist
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License Number | RC1483
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License Number State | DC
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