Individual
DR. TEWODROS GEDAMU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001068
VA
152W00000X
Optometrist
OP1000039
DC
152W00000X
Optometrist
TA 1661
MD
Other
Enumeration date
08/31/2006
Last updated
06/21/2014
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