Provider Demographics
NPI:1710556253
Name:ALEMAW, ABITY ABEBE
Entity Type:Individual
Prefix:
First Name:ABITY
Middle Name:ABEBE
Last Name:ALEMAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABIOT
Other - Middle Name:ABEBE
Other - Last Name:ALEMAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32354 GLEN CV
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3609
Mailing Address - Country:US
Mailing Address - Phone:773-704-4854
Mailing Address - Fax:
Practice Address - Street 1:32354 GLEN CV
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3609
Practice Address - Country:US
Practice Address - Phone:773-704-4854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-20
Last Update Date:2021-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist