Individual
MR. SHIFERAW AWLACHEW SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ETC
Contact information
Practice address
14 PLEASANT ST, EVERETT, MA 02149-2811
(781) 300-1774
Mailing address
14 PLEASANT ST, EVERETT, MA 02149-2811
(781) 300-1774
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
DA08481
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
451734099
—
MA
Enumeration date
02/15/2020
Last updated
02/15/2020
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