Provider Demographics
NPI:1669829867
Name:ALEMU, SEBLE (MAOM)
Entity Type:Individual
Prefix:
First Name:SEBLE
Middle Name:
Last Name:ALEMU
Suffix:
Gender:F
Credentials:MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SEBE ALEMU
Mailing Address - Street 2:
Mailing Address - City:ADDIS ABABA
Mailing Address - State:NONE
Mailing Address - Zip Code:182854
Mailing Address - Country:ET
Mailing Address - Phone:25191-148-2310
Mailing Address - Fax:
Practice Address - Street 1:12 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-3009
Practice Address - Country:US
Practice Address - Phone:617-489-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No171100000XOther Service ProvidersAcupuncturist