Provider Demographics
NPI:1003509993
Name:BEKELE, HADDIS
Entity Type:Individual
Prefix:
First Name:HADDIS
Middle Name:
Last Name:BEKELE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18246 E DORADO DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-5918
Mailing Address - Country:US
Mailing Address - Phone:720-628-5998
Mailing Address - Fax:
Practice Address - Street 1:18246 E DORADO DR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-5918
Practice Address - Country:US
Practice Address - Phone:720-628-5998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)