Provider Demographics
NPI:1598549032
Name:GHEBREHIWET, ALEXANDER G
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:G
Last Name:GHEBREHIWET
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 1:105 PARIS CIR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-8223
Mailing Address - Country:US
Mailing Address - Phone:720-987-7621
Mailing Address - Fax:
Practice Address - Street 1:105 PARIS CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8223
Practice Address - Country:US
Practice Address - Phone:720-987-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)