Provider Demographics
NPI:1609762541
Name:GEBREMARIAM, FREWOINIE
Entity type:Individual
Prefix:
First Name:FREWOINIE
Middle Name:
Last Name:GEBREMARIAM
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 1:5501 BRADLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1003
Mailing Address - Country:US
Mailing Address - Phone:571-866-0075
Mailing Address - Fax:
Practice Address - Street 1:5501 BRADLEY BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1003
Practice Address - Country:US
Practice Address - Phone:571-866-0075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)