Provider Demographics
NPI:1629787346
Name:ABRAHA, ZEWDU MENGESHA
Entity Type:Individual
Prefix:
First Name:ZEWDU MENGESHA
Middle Name:
Last Name:ABRAHA
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 1:7437 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2455
Mailing Address - Country:US
Mailing Address - Phone:202-655-9786
Mailing Address - Fax:
Practice Address - Street 1:7437 MORRISON DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2455
Practice Address - Country:US
Practice Address - Phone:202-655-9786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00204192374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide