Individual
SAMEL T GEBRESILASIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2053 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1165
(404) 513-6908
Mailing address
2053 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1165
(404) 513-6908
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
057597061
GA
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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