Provider Demographics
NPI:1881499820
Name:MEKONEN, ZEWIDU BELAY
Entity type:Individual
Prefix:
First Name:ZEWIDU
Middle Name:BELAY
Last Name:MEKONEN
Suffix:
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 1:14427 INNSBRUCK CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-2256
Mailing Address - Country:US
Mailing Address - Phone:240-438-1462
Mailing Address - Fax:
Practice Address - Street 1:14427 INNSBRUCK CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2256
Practice Address - Country:US
Practice Address - Phone:240-438-1462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD10275221216374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide