Provider Demographics
NPI:1497250245
Name:SHIFERAW, MENBERE F
Entity Type:Individual
Prefix:
First Name:MENBERE
Middle Name:F
Last Name:SHIFERAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8332 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-3327
Mailing Address - Country:US
Mailing Address - Phone:301-364-7629
Mailing Address - Fax:
Practice Address - Street 1:8332 12TH AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-3327
Practice Address - Country:US
Practice Address - Phone:301-364-7629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide