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General NPI Number Information
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NPI Number | 1780437624
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Entity Type | Individual
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Provider Name | MALACHI ABEBE
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Gender | Male
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 04/14/2024
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Provider Practice Location Address
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Address Line | 520 W ST NW
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City | WASHINGTON
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State | DC
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Zip | 20059-1021
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Country | US
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Telephone | 202-806-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 3123 HAWTHORNE DR NE
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City | WASHINGTON
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State | DC
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Zip | 20017-1040
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Country | US
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Telephone | 402-904-2738
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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