Provider Demographics
NPI:1497476998
Name:SHIFERAW, SELAMAWIT
Entity Type:Individual
Prefix:
First Name:SELAMAWIT
Middle Name:
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 1:5714 S FULTONDALE CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-4480
Mailing Address - Country:US
Mailing Address - Phone:303-594-3495
Mailing Address - Fax:
Practice Address - Street 1:5714 S FULTONDALE CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-4480
Practice Address - Country:US
Practice Address - Phone:303-594-3495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant