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General NPI Number Information
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NPI Number | 1992310791
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Entity Type | Individual
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Provider Name | EYOB TESFAMICHAEL
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Gender | Male
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 8025 13TH ST APT 312
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City | SILVER SPRING
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State | MD
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Zip | 20910-5817
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Country | US
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Telephone | 202-793-9766
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 13TH ST APT 312
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City | SILVER SPRING
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State | MD
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Zip | 20910-5817
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Country | US
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Telephone | 202-793-9766
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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