Provider Demographics
NPI:1023304409
Name:YEMANE-MERRIWETHER, SELAMAWIT (MD)
Entity type:Individual
Prefix:DR
First Name:SELAMAWIT
Middle Name:
Last Name:YEMANE-MERRIWETHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 W APOLLO RD
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-6910
Mailing Address - Country:US
Mailing Address - Phone:917-957-1457
Mailing Address - Fax:
Practice Address - Street 1:4101 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2616
Practice Address - Country:US
Practice Address - Phone:301-383-2559
Practice Address - Fax:301-383-2549
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD76825207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine