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NPI Code Detail

MEDICARE: GEDION MAMO ADMASSU

MEDICARE: GEDION MAMO ADMASSU
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
1172A00000XDriver9371686423IN

General Provider Information

NPI Number : 1821939331
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEDION MAMO ADMASSU
Provider Business Mailing Address
First Line : 309 SPRING FOREST CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-6723
Country : US
Telephone Number : 260-304-7144
Fax Number :
Provider Business Practice Location Address
First Line : 309 SPRING FOREST CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-6723
Country : US
Telephone Number : 260-304-7144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2026
Last Update Date : 04/01/2026

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Directions to “ GEDION MAMO ADMASSU ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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