Individual
MR. HAILESELASSIE TESFAMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
117 BRENTMEADE DR, YORKTOWN, VA 23693-2592
(757) 303-7189
(757) 867-7857
Mailing address
117 BRENTMEADE DR, YORKTOWN, VA 23693-2592
(757) 303-7189
(757) 867-7857
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172A00000X-DRIVER
LOGISTICARE
—
Enumeration date
08/11/2017
Last updated
07/21/2022
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