Provider Demographics
NPI:1457612277
Name:MAMO, MEHRET F
Entity Type:Individual
Prefix:
First Name:MEHRET
Middle Name:F
Last Name:MAMO
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 1:12630 VEIRS MILL RD APT 1001
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-3572
Mailing Address - Country:US
Mailing Address - Phone:202-631-2901
Mailing Address - Fax:
Practice Address - Street 1:12630 VEIRS MILL RD APT 1001
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20853-3572
Practice Address - Country:US
Practice Address - Phone:202-631-2901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide