Individual
ESUBALEW TADESSE AMERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5403 ROBINSON LN, WILLIAMSBURG, VA 23188-2920
(757) 272-6331
Mailing address
5403 ROBINSON LN, WILLIAMSBURG, VA 23188-2920
(757) 272-6331
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
901731
VA
347C00000X
Private Vehicle
901731
VA
Other
Enumeration date
05/30/2018
Last updated
05/30/2018
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