Provider Demographics
NPI:1871266205
Name:DAWALIBY, RAWA
Entity Type:Individual
Prefix:
First Name:RAWA
Middle Name:
Last Name:DAWALIBY
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:PO BOX 101181
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80250-1181
Mailing Address - Country:US
Mailing Address - Phone:303-669-6666
Mailing Address - Fax:
Practice Address - Street 1:5586 S IRELAND ST
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3643
Practice Address - Country:US
Practice Address - Phone:303-669-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriver