MEDICARE: TADELE ADEBO ABEBE SR.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	3626	DC

General Provider Information

NPI Number	:	1154280998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TADELE ADEBO ABEBE SR.

Provider Business Mailing Address
First Line	:	2615 EVARTS ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1430
Country	:	US
Telephone Number	:	202-374-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 EVARTS ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20018-1430
Country	:	US
Telephone Number	:	202-374-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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