Provider Demographics
NPI:1801579693
Name:YESGAT, ADDISALEM D
Entity type:Individual
Prefix:
First Name:ADDISALEM
Middle Name:D
Last Name:YESGAT
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 1:20992 E 40TH PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-8216
Mailing Address - Country:US
Mailing Address - Phone:303-601-0519
Mailing Address - Fax:
Practice Address - Street 1:20992 E 40TH PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-8216
Practice Address - Country:US
Practice Address - Phone:303-601-0519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle