Individual
KIDIST HUNACHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26 LEWALLEN DR, NEWPORT NEWS, VA 23608-2249
(202) 642-8881
Mailing address
26 LEWALLEN DR, NEWPORT NEWS, VA 23608-2249
(202) 642-8881
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T58071614
VA
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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