Provider Demographics
NPI:1366032666
Name:TEREGA, MESAY
Entity Type:Individual
Prefix:
First Name:MESAY
Middle Name:
Last Name:TEREGA
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 1:306 KARL LINN DR APT 428
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-6987
Mailing Address - Country:US
Mailing Address - Phone:702-722-4219
Mailing Address - Fax:
Practice Address - Street 1:306 KARL LINN DR APT 428
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-6987
Practice Address - Country:US
Practice Address - Phone:702-722-4219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)