Provider Demographics
NPI:1972281012
Name:GEBREHIWOT, ALEM (MEDICAL ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ALEM
Middle Name:
Last Name:GEBREHIWOT
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 S MILAM ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79118-8810
Mailing Address - Country:US
Mailing Address - Phone:719-400-3084
Mailing Address - Fax:
Practice Address - Street 1:5805 S MILAM ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79118-8810
Practice Address - Country:US
Practice Address - Phone:719-400-3084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver