MEDICARE: YEMESERACH KETEMA

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)

General Provider Information

NPI Number	:	1902747348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YEMESERACH KETEMA

Provider Business Mailing Address
First Line	:	5382 LAREDO CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-6498
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5382 LAREDO CT
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80239-6498
Country	:	US
Telephone Number	:	720-231-9243
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 “ YEMESERACH KETEMA ” Practice Location

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