Provider Demographics
NPI:1245857846
Name:TESFAMARIAM, ALEM N/A SR
Entity type:Individual
Prefix:
First Name:ALEM
Middle Name:N/A
Last Name:TESFAMARIAM
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1227
Mailing Address - Country:US
Mailing Address - Phone:443-438-5220
Mailing Address - Fax:443-438-5220
Practice Address - Street 1:3233 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1227
Practice Address - Country:US
Practice Address - Phone:443-438-5220
Practice Address - Fax:443-438-5220
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily